ê

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ìíXî"#ïð3fEIJñòㄭᐕ‫ޔ‬20 4ઍ෸߮ 30 4ઍᅚᕈߦ߅ߌࠆ૕ᩰಽߩಽ߇ᄢ߈ߊᄌൻߒߡ޿ࠆ‫ޕ‬ૐ૕㊀㧔߿ߖ㧕ߩ⠪㧔BMI18.5㧕ߩഀวߪ‫ޔ‬1983(@A 58)ᐕߢ 20 4ઍᅚᕈ 14.68‫ޔ‬30
4ઍᅚᕈ 7.88ߢ޽ߞߚߩ߇‫ޔ‬2003㧔ᐔᚑ 15㧕ᐕߢߪ 20 4ઍᅚᕈ 23.48‫ޔ‬30 4ઍᅚ
ᕈ 14.78ߣჇടߒߡ޿ࠆ‫৻ޕ‬ᣇ‫ޔ‬⢈ḩߩ⠪ߩഀว㧔BMIÊ25.0㧕ߪ‫ޔ‬1983(@A 58)ᐕ
ߢ 20 4ઍᅚᕈ 8.78‫ޔ‬30 4ઍᅚᕈ 13.58‫ޔ‬2003㧔ᐔᚑ 15㧕ᐕߢߪ 20 4ઍᅚᕈ 8.18‫ޔ‬
30 4ઍᅚᕈ 12.68ߣ £ê޿ߩ⁁ᴫߦ޽ࠆ‫ޕ‬ߎࠇ߹ߢ߽ᅧᆼ∝㧔ᅧᆼ∝㧕 ߩu^߆ࠄᅧᆼߩㆡಾߥ૕㊀Ⴧട㊂߇ផᅑߐࠇߡ߈ߡ޿ࠆ߇‫ޔ‬ᅧᆼ೨ߩ૕ᩰ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ޟ߿ޠ‬¥ߟ߁‫ߚߞ޽ߢޠ‬ᅚᕈߢ‫ޔ‬ᅧᆼߩ૕㊀Ⴧട㊂߇ 7kg £ḩߩวߦߪૐ಴↢૕㊀ఽࠍ಴↥ߔࠆ࡝ࠬࠢ߇ªqߦ޿ߎߣߥߤ‫ߥߚޔ‬⍮⷗߽ႎ๔ߐࠇߡ߈ߡ޿ࠆ‫ޕ‬ߎߩࠃ߁ߦ‫ޔ‬ᅧᆼߩ૕ᩰ෸߮ᅧᆼߩ૕㊀Ⴧട㊂ߦࠃߞߡ‫ޔ‬಴↢ఽߩ૕㊀෸߮ᅧᆼ∝㧔ᅧᆼ∝㧕‫ޔ‬ಾ‫ޔ‬ಽᄢ㊂಴ߥߤߩ⁁ᴫߦ¤߇ߺࠄࠇࠆ‫ޔߡߞ߇ߚߒޕ‬૕㊀Ⴧട㊂߇%৻⊛ߦ²³ߐࠇࠆߎߣߩߥ޿ࠃ߁‫ޔ‬ᅧᇚ୘‫ߩޘ‬૕ᩰߥߤߦߒߚኻᔕࠍⴕ߁ߎߣ߇㊀ⷐߢ޽ࠆ‫ߚߒߦ߆ࠄ~ࠍ! ߩࠄࠇߎޔߦ߼ߚߩߘޕ‬਄ߢ‫⦟ࠅࠃޔ‬øߥᅧᆼ⁁&ࠍóôߔࠆSߣߟߩ⋡቟ߣߒߡ‫ޔ‬ᅧᆼᦼߦ߅ߌࠆᦸ߹ߒ޿૕
㊀Ⴧട㊂ࠍឭ␜ߔࠆߎߣ߇߼ࠄࠇߡ޿ࠆ‫ޕ‬

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ìíXî"#ïð3fEóô਄å°±ࠍ¥߹߃‫ޔ‬ᅧᆼᦼߦ߅ߌࠆᦸ߹ߒ޿૕㊀Ⴧട㊂ࠍᅧᆼߩ૕ᩰಽ#ߦ‫ޟ‬ᅧᆼᦼ[ࠍㅢߒߡߩផᅑ૕㊀Ⴧട㊂‫ޠ‬෸߮‫ޟ‬ᅧᆼᦼ߆ࠄuᦼߦ߅ߌࠆ 1 ¥[޽ߚࠅߩផᅑ૕㊀Ⴧട㊂‫ߡߒߣޠ‬ᬌ⸛ࠍⴕߞߚ‫ޕ‬XYõFGH૕ᩰಽߪ‫ޔ‬ᣣ⢈ḩቇળߩቯၮḰߦᓥ޿‫ޔ‬BMI [Body Mass Index*૕㊀(kg)/‫ޔ‬18.5 ¤਄ 25.0 £ḩࠍ‫ޟ‬¥ߟ߁‫ޔޠ‬25.0 ¤਄ࠍ‫ޟ‬⢈(m)2 ] 18.5 £ḩࠍ‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ޠ‬ḩ‫ ࠆߔߣޠ‬3 ಽߣߒߚ‫ޕ‬

ȝ 72 ȝ

ԙᅧᆼోᦼ㑆ࠍㅢߒߡߩផᅑ૕㊀Ⴧട㊂ߦߟ޿ߡᅧᆼᦼ[ࠍㅢߒߡߩផᅑ૕㊀Ⴧട㊂ߪ‫ޔ‬ಽY೨ߩ૕㊀ߣᅧᆼ೨ߩ૕㊀ߩ}ߣߒ‫ޔ‬
ฦ⒳ಽ⇣Ᏹ 1 ߣߩ !ࠍ⷗ߚ਄ߢ૕㊀Ⴧട㊂ߩ9:ࠍ␜ߒߚ߽ߩߢ޽ࠆ‫ޕ‬
ฦ⒳⺞ᩏ⎇ⓥ㧔ෳ⠨Vෳ㧕ࠍಽ"ߒ‫ޔ‬ᬌ⸛ߒߚ‫ޔ‬ᅧᆼᦼ[ࠍㅢߒߡߩផᅑ
૕㊀Ⴧട㊂ߪ‫ޔ‬૕ᩰಽ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ߩޠ‬ว‫ޔ‬9ß12kg‫ޔ‬‫ޟ‬¥ߟ߁‫ߩޠ‬ว‫ޔ‬7ß
12kg‫ޔ‬‫ޟ‬⢈ḩ‫ߩޠ‬ว‫ޔ‬୘#ߦኻᔕߒߡ޿ߊߎߣߣߒߚ㧔Z 1 ෳ㧕‫ޕ‬
1 ૐ಴↢૕㊀ఽ෸߮§ᄢఽ㧔4,000¤਄㧕಴↥‫ޔ‬ᅧᆼ∝㧔ᅧᆼ∝㧕‫ޔ‬ಾಽ‫ޔ‬¨ಽ‫ޔ‬ಽᄢ㊂಴╬ߥ߅‫ޔ‬૕ᩰಽ‫ޟ‬¥ߟ߁‫ߩޠ‬ว‫ޔ‬BMI ߩ9:߇ 18.5ß25.0 ߣU޿߇‫ޔ‬BMI ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕
‫ߦޠ‬ㄭ޿วߦߪផᅑ૕㊀Ⴧട㊂ߩ਄å©ߦㄭ޿9:ࠍ‫ޔ‬‫ޟ‬⢈ḩ‫ߦޠ‬ㄭ޿วߦߪផᅑ૕㊀Ⴧട㊂ߩਅå©ߦૐ޿9:ࠍផᅑߔࠆߎߣ߇ᦸ߹ߒ޿‫ޕ‬߹ߚ‫ޔ‬‫ޟ‬⢈ḩ‫ߩޠ‬วߦߪ‫ޔ‬ᅧᆼµ¶∛‫ޔ‬ᅧᆼ∝㧔ᅧᆼ∝㧕ߥߤߩ⊒∝ߩu^߆ࠄ୘#ߩኻᔕ߇ᔅⷐߣߥࠆ߇‫ޔ‬BMI ߇ 25.0 ࠍ߿߿C߃ࠆ`ߩวߪ‫߅ޔ‬

߅ࠃߘ 5kg ࠍ⋡቟ߣߒ‫ߊߒ?ޔ‬C߃ࠆวߦߪ‫ޔ‬7ߩ࡝ࠬࠢ╬ࠍ⠨ߒߥ߇ࠄ‫⊛¸·ޔ‬ߥ⁁ᴫࠍ〯߹߃‫ޔ‬୘#ߦኻᔕߒߡ޿ߊ‫ޕ‬Ԛ‫ޟ‬ᅧᆼਛᦼ㧖2 ߆ࠄᧃᦼ㧖3 ߦ߅ߌࠆ  ㅳ㑆޽ߚࠅߩផᅑ૕㊀Ⴧട㊂‫ߦޠ‬ߟ޿ߡᅧᆼᦼ߆ࠄuᦼߦ߅ߌࠆ 1 ¥[޽ߚࠅߩផᅑ૕㊀Ⴧട㊂ߪ‫ߦ⊛⚻ޔ‬u‫ޔ‬vwߒ
ߡ޿ߊߚ߼ߩ⋡቟ߣߒߡ␜ߒߚ߽ߩߢ޽ࠆ‫ޕ‬
ฦ⒳⺞ᩏ⎇ⓥ㧔ෳ⠨Vෳ㧕ࠍಽ"ߒ‫ޔ‬ᬌ⸛ߒߚ‫ޔ‬૕ᩰಽ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ޠ‬෸߮‫ޟ‬¥ߟ߁‫ߩޠ‬ว‫ޔ‬0.3ß0.5kg/¥ߣߒ‫ޔ‬‫ޟ‬⢈ḩ‫ߩޠ‬ว‫ޔ‬୘#ߦኻᔕߒߡ޿ߊ
ߎߣߣߒߚ㧔Z 2 ෳ㧕‫ޕ‬ߥ߅‫ޔ‬ᅧᆼsᦼߦߟ޿ߡߪ૕㊀Ⴧടߦ ߔࠆM↪ߥs࡯k߇+ߒ޿ߎߣߥߤ߆ࠄ‫ޔ‬' ¥[޽ߚࠅߩផᅑ૕㊀Ⴧട㊂ߩ⋡቟ࠍ␜ߒߡ޿ߥ޿ߚ߼‫⁁ߥ⊛¸·ߩߤߥࠅࠊߟޔ‬ᴫࠍ〯߹߃‫ޔ‬୘#ߦኻᔕߒߡ޿ߊ‫ޕ‬
2 ᅧᆼᦼ*ᅧᆼ 16ß28 ¥£ḩ

3 ᅧᆼuᦼ*ᅧᆼ 28 ¥¤)㧔ᣣ↥⑼ᇚੱ⑼ቇળª ↥⑼ᇚੱ⑼↪«⸃⺑v´ 2 㧕

ȝ 73 ȝ⴫㧝૕ᩰ඙ಽ೎ᅧᆼోᦼ㑆ࠍㅢߒߡߩផᅑ૕㊀Ⴧട㊂૕ᩰ඙ಽ

ផᅑ૕㊀Ⴧട㊂ૐ૕㊀㧔߿ߖ㧕㧦BMI8.5 ᧂḩ

9㨪2kg߰߁㧦BMI8.5 એ਄ 25.0 ᧂḩ

7㨪2kg۲ḩ㧦BMI25.0 એ਄୘೎ኻᔕ۲2ߟ⢈࡮૕ᩰ඙ಽߪ㕖ᅧᆼᤨߩ૕ᩰߦࠃࠆ‫ޕ‬
࡮BMI㧔Body Mass Index㧕㧦૕㊀(kg)/り㐳(m)2۲૕ᩰ඙ಽ߇‫ߩޠ߁ߟ߰ޟ‬႐ว‫ޔ‬BMI ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ߦޠ‬ㄭ޿႐วߦߪផᅑ૕
㊀Ⴧട㊂ߩ਄㒢஥ߦㄭ޿▸࿐ࠍ‫ޔ‬‫ޟ‬⢈ḩ‫ߦޠ‬ㄭ޿႐วߦߪផᅑ૕㊀Ⴧട㊂ߩਅ㒢஥ߦૐ޿▸࿐ࠍផᅑߔࠆߎߣ߇ᦸ߹ߒ޿‫ޕ‬

۲2

BMI ߇ 25.0 ࠍ߿߿⿥߃ࠆ⒟ᐲߩ႐วߪ‫ ߘࠃ߅߅ޔ‬5kg ࠍ⋡቟ߣߒ‫߃⿥ߊߒ⪺ޔ‬ࠆ႐วߦߪ‫ࠍ╬ࠢࠬ࡝ߩઁޔ‬⠨ᘦߒߥ߇ࠄ‫⥃ޔ‬ᐥ⊛ߥ⁁ᴫࠍ〯߹߃‫ޔ‬୘೎ߦኻᔕߒߡ޿ߊ‫ޕ‬⴫㧞૕ᩰ඙ಽ೎ ᅧᆼਛᦼ߆ࠄᧃᦼߦ߅ߌࠆ  ㅳ㑆޽ߚࠅߩផᅑ૕㊀Ⴧട㊂૕ᩰ඙ಽ

1 ㅳ㑆޽ߚࠅߩ
ផᅑ૕㊀Ⴧട㊂ૐ૕㊀㧔߿ߖ㧕㧦BMI8.5 ᧂḩ

0.3㨪
0.3㨪0.5kg/
0.5kg/ㅳ߰

0.3㨪
0.3㨪0.5kg/
0.5kg/ㅳ⢈ߟ߁㧦BMI8.5 એ਄ 25.0 ᧂḩ
ḩ㧦BMI25.0 એ਄୘೎ኻᔕ࡮૕ᩰ඙ಽߪ㕖ᅧᆼᤨߩ૕ᩰߦࠃࠆ‫ޕ‬
࡮BMI㧔Body Mass Index㧕㧦૕㊀(kg)/り㐳(m)2࡮ᅧᆼೋᦼߦߟ޿ߡߪ૕㊀Ⴧടߦ㑐ߔࠆ೑↪น⢻ߥ࠺࡯࠲߇ਲߒ޿ߎߣߥߤ߆ࠄ‫ޔ‬ ㅳ㑆޽ߚࠅߩផᅑ૕㊀Ⴧട㊂ߩ⋡቟ࠍ␜ߒߡ޿ߥ޿ߚ߼‫⥃ߩߤߥࠅࠊߟޔ‬ᐥ⊛ߥ⁁ᴫࠍ〯߹߃‫ޔ‬୘೎ߦኻᔕߒߡ޿ߊ‫ޕ‬

ȝ 74 ȝ

㧔㧟㧕‫ޟ‬ᅧᆼᦼߩ⥋ㆡ૕㊀Ⴧട࠴ࡖ࡯࠻‫߼ߣ߹ߩޠ‬Ԙ૕ᩰ඙ಽ೎

ᅧᆼోᦼ㑆ࠍㅢߒߡߩផᅑ૕㊀Ⴧട㊂ߩ⸳ቯߦߟ޿ߡ

㕖ᅧᆼᤨߦ߅ߌࠆ૕ᩰ඙ಽߣ࡝ࠬࠢߣߩ㑐ㅪߦߟ޿ߡߪ‫ޔ‬㕖ᅧᆼᤨߦ‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ߦޠ‬ዻߔࠆ⠪ߪ‫ޔ‬ૐ಴↢૕㊀ఽಽᇂ 㧕2㧕߿ሶችౝ⢝ఽ⊒⢒ㆃᑧ㧔IUGR㧕2㧕3㧕‫ޔ‬ಾㄼᣧ↥߿ᣧ↥ 㧕2㧕4㧕‫ ⴊ⽺ޔ‬㧕ߩ࡝ࠬࠢ߇㜞߹ࠅ‫ޔ‬‫ޟ‬⢈ḩ‫ߦޠ‬ዻߔࠆ⠪ߪ‫♧ޔ‬ዩ∛ 5㧕6㧕7㧕߿Ꮒᄢఽಽᇂ 7㧕‫ޔ‬Ꮲ₺ಾ㐿ಽᇂ 5㧕6㧕8㧕‫ޔ‬ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕5㧕㨪0㧕ߩ࡝ࠬࠢ߇㜞߹ࠆ‫ޕ‬߹ߚ‫ޔ‬ᅧᆼᦼߦ߅ߌࠆ૕㊀Ⴧട㊂ߣ࡝ࠬࠢߣߩ㑐ㅪߦߟ޿ߡߪ‫ޔ‬ᅧᆼᦼߦ૕㊀Ⴧട
㊂߇⪺ߒߊዋߥ޿႐วߦߪ‫ޔ‬ૐ಴↢૕㊀ఽಽᇂ 㧕㨪3㧕߿ಾㄼᵹ↥ 0㧕‫ޔ‬ಾㄼᣧ↥ 0㧕ߩ࡝ࠬࠢ߇㜞߹ࠅ‫ޔ‬૕㊀Ⴧട㊂߇⪺ߒߊᄙ޿႐วߦߪ‫ޔ‬೨ᦼ⎕᳓ 4㧕߿ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕0㧕4㧕‫ޔ‬Ꮒᄢఽಽᇂ 6㧕5㧕‫ޔ‬Ꮲ₺ಾ㐿ಽᇂ 8㧕5㧕6㧕‫ޔ‬ಽᇂᤨߩ಴ⴊ㊂ㆊᄙ 7㧕‫ޔ‬⟠᳓ᷙỘ࡮⢝ఽᔃᜉᢙ⇣Ᏹ 5㧕ߩ࡝ࠬࠢ߇㜞߹ࠆ‫ޕ‬ߐࠄߦ‫ޔ‬㕖ᅧᆼᤨߦ߅ߌࠆ૕ᩰ඙ಽߣᅧᆼᦼߦ߅ߌࠆ૕㊀Ⴧട㊂ߣߩ࡝ࠬࠢߩ㑐ㅪߦߟ޿ߡߪ‫ޔ‬㕖ᅧᆼᤨߦ‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ޠ‬‫ޟޠ߁ߟ߰ޟ‬⢈ḩ‫ߩࠇߕ޿ߩޠ‬૕ᩰ඙ಽߦዻ
ߒߡ޿ߡ߽‫ޔ‬ᅧᆼᦼߩ૕㊀Ⴧട㊂߇ዋߥ޿⠪ߢߪૐ಴↢૕㊀ఽߩ࡝ࠬࠢ߇㜞߹ࠆ 2㧕3㧕‫ޕ‬㕖ᅧᆼᤨߩ૕ᩰ඙ಽ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ߦޠ‬ዻߔࠆ⠪ߢᅧᆼᦼߩ૕㊀Ⴧട㊂߇ᄙ޿႐ว
ߦߪ‫ޔ‬Ꮲ₺ಾ㐿ߩ࡝ࠬࠢ߇㜞߹ࠅ 8㧕‫ޔ‬㕖ᅧᆼᤨߩ૕ᩰ඙ಽ߇‫ߦޠ߁ߟ߰ޟ‬ዻߔࠆ⠪ߢᅧ
ᆼᦼߩ૕㊀Ⴧട㊂߇ᄙ޿႐วߦߪ‫ޔ‬heavy-for-dates ఽ 3㧕㧔࿷⢝ㅳᢙߦኻߒߡ಴↢૕㊀
߇㊀޿ఽࠍ޿߁‫ޕ‬㧕߿Ꮲ₺ಾ㐿 8㧕ߩ࡝ࠬࠢ߇㜞߹ࠆ‫ߚ߹ޕ‬㕖ᅧᆼᤨߩ૕ᩰ඙ಽ߇‫ޟ‬⢈ḩ‫ޠ‬ߦዻߔࠆ⠪ߢᅧᆼᦼߩ૕㊀Ⴧട㊂߇ᄙ޿႐วߦߪ‫ޔ‬ಽᇂᤨߩ಴ⴊ㊂߇ㆊᄙߦߥࠆ࡝ࠬ
ࠢ߇㜞߹ࠆ 7㧕ߣߐࠇࠆ‫ޕ‬࿖ౝߢߪ‫ޔ‬Უ૕ߩ㕖ᅧᆼᤨߩ૕ᩰ߇⠨ᘦߐࠇߚ⎇ⓥ߇ዋߥߊ‫ߢ߹ࠇߎޔ‬ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕੍㒐ߩⷰὐ߆ࠄᅧᆼਛߩㆡಾߥ૕㊀Ⴧട㊂ߪ‫ޔ‬BMI8 ᧂḩߩ߿ߖဳᅧᇚߢߪ 0㨪2kg Ⴧ‫ޔ‬BMI8㨪24 ߩᮡḰဳᅧᇚߢߪ 7㨪0kg Ⴧ‫ޔ‬BMI 24 એ਄ߩ⢈ḩᅧᇚߢߪ 5㨪7kg Ⴧߣផᅑߐࠇߡ߈ߚ 9㧕‫ᦨߚ߹ޕ‬ㄭߩ⎇ⓥߢߪ‫ޔ‬ಽᇂ⁁ᴫ߿ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕੍㒐ߩⷰὐ߆ࠄ‫ޔ‬‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫⥋ߩޠ‬ㆡ૕㊀Ⴧട㊂ࠍ 0㨪4kg‫ޔ‬‫ ࠍޠ߁ߟ߰ޟ‬7㨪0kg‫ޔ‬‫ޟ‬⢈ḩ‫ ࠍޠ‬7kg ᧂḩߣផᅑߔࠆႎ๔߽޽ࠆ 3㧕‫ޕ‬߹ߚ੹⥸‫ޔ‬ᱜᦼ↥න⢝ఽ㧔㧺㧩5,035㧕ߩಽᇂ⸥㍳߆ࠄ‫ޔ‬ᅧᆼว૬∝ߩ⁁ᴫ‫ޔ‬ಽᇂᤨ
ߩ಴ⴊ㊂‫ޔ‬ಽᇂᚲⷐᤨ㑆ߦ㑐ߔࠆᖱႎ߇ᓧࠄࠇߚ 780 ଀ߦߟ޿ߡ‫ޔ‬Უⷫߩᅧᆼ೨ߩ૕
ᩰߣ૕㊀Ⴧട㊂ߣૐ಴↢૕㊀ఽ಴↥࡮Ꮲ₺ಾ㐿ಽᇂ࡮ㆫᑧಽᇂ࡮ಽᇂᤨᄢ㊂಴ⴊߣߩ㑐ㅪࠍ⸃ᨆߒ‫ޔ‬Უⷫߩ㕖ᅧᆼᤨߩ૕ᩰߣ૕㊀Ⴧട㊂ߩ㑐ㅪࠍᬌ⸛ߒߚ 20㧕‫⚿ߩߎޕ‬ᨐ‫ޔ‬‫ޟ‬ૐ

ȝ 75 ȝ

૕㊀㧔߿ߖ㧕‫ޔߪߢޠ‬૕㊀Ⴧട㊂߇ 9㨪2kg ߩ႐วߦᲧߴ‫ޔ‬ૐ಴↢૕㊀ఽࠍ಴↥ߔࠆ࡝
ࠬࠢ߇ 5kg ᧂḩ‫ޔ‬5㨪7kg‫ޔ‬7㨪9kg ߩ႐วߢ᦭ᗧߦ㜞ߊߥࠅ‫ޔ‬Ꮲ₺ಾ㐿ಽᇂߦߟ޿ߡ߽‫ޔ‬
2㨪5kg ߩ႐วߢ᦭ᗧߦ㜞ߊߥࠆ߇‫ޔ‬Ꮒᄢఽ಴↥߿ㆫᑧಽᇂ‫ޔ‬ಽᇂᤨᄢ㊂಴ⴊߢߪ૕
㊀Ⴧട㊂ߣߩ㑐ㅪߪߺࠄࠇߥ߆ߞߚ‫ޕ‬߹ߚ‫ޔ‬‫ޔߪߢޠ߁ߟ߰ޟ‬૕㊀Ⴧട㊂߇㧣㨪2kg ߩ႐วߦᲧߴ‫ޔ‬ૐ಴↢૕㊀ఽࠍ಴↥ߔࠆ࡝ࠬࠢ߇ 2㨪5kg‫ޔ‬5kg એ਄ߢ᦭ᗧߦૐߊ‫ޔ‬Ꮲ₺ಾ㐿ಽᇂߦߟ޿ߡߪ 5kg એ਄ߢ᦭ᗧߦ㜞ߊߥࠆ‫ߚ߹ޕ‬Ꮒᄢఽ಴↥ߩ࡝ࠬࠢߪ 2㨪5kg ߢ᦭ᗧߦ㜞ߊ‫ޔ‬ಽᇂᤨᄢ㊂಴ⴊߩ࡝ࠬࠢߪ 2㨪5kg‫ޔ‬5kg એ਄ߢ᦭ᗧߦ㜞޿߇‫ޔ‬ㆫᑧಽᇂߣ૕㊀Ⴧട㊂ߣߩ㑐ㅪߪߺࠄࠇߥ߆ߞߚ‫ޔ߅ߥޕ‬‫ߩޠ߁ߟ߰ޟ‬ಽᨆ߆ࠄ‫ޔ‬૕㊀Ⴧട㊂ߦ㑐ࠊࠅߥߊ‫ޔ‬㕖ᅧᆼᤨߩ BMI߇  ᷫዋߔࠆߣ‫ޔ‬ૐ಴↢૕㊀ఽ಴↥ߩ࡝ࠬࠢߪ .6 ୚‫ޔ‬ㆫᑧಽᇂߩ࡝ࠬࠢߪ .32 ୚ߣߥࠅ‫ ޔ‬ჇടߔࠆߣᏂᄢఽ಴↥࡝ࠬࠢߪ .46 ୚‫ޔ‬Ꮲ₺ಾ㐿ಽᇂߩ࡝ࠬࠢߪ .2 ୚‫ޔ‬
ಽᇂᤨᄢ㊂಴ⴊߩ࡝ࠬࠢߪ .09 ୚ߢ޽ࠆߣႎ๔ߐࠇߚ‫ޟޕ‬⢈ḩ‫ޔߪߢޠ‬ૐ಴↢૕㊀ఽ಴↥‫ޔ‬Ꮒᄢఽ಴↥‫ޔ‬ㆫᑧಽᇂ߿ಽᇂᤨᄢ㊂಴ⴊߣ૕㊀Ⴧട㊂ߣߩ㑐ㅪߪߺࠄࠇߥ߆ߞ
ߚ‫ޕ‬એ਄ߩࠃ߁ߥ⚿ᨐࠍ߰߹߃‫ޔ‬ᅧᆼోᦼ㑆ࠍㅢߒߡߩផᅑ૕㊀Ⴧട㊂ߪ‫ޔ‬‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ߩޠ‬႐วߪ 9㨪2kg‫ޔ‬‫ߩޠ߁ߟ߰ޟ‬႐วߪ 7㨪2kg ߣߒ‫ޔ‬‫ޟ‬⢈ḩ‫ߩޠ‬႐วߪ‫ޔ‬୘೎ߦኻᔕߒߡ޿ߊߎߣߣߒ‫ޔ‬BMI ߇ 25.0 ࠍ߿߿⿥߃ࠆ⒟ᐲߩ႐วߪ‫ޔ‬߅߅ࠃߘ 5kg ࠍ⋡቟ߣߒ‫ޔ‬⪺ߒߊ⿥߃ࠆ႐วߦߪ‫ࠍ╬ࠢࠬ࡝ߩઁޔ‬⠨ᘦߒߥ߇ࠄ‫⥃ޔ‬ᐥ⊛ߥ⁁ᴫࠍ〯߹߃‫ޔ‬୘೎ߦኻᔕߒߡ޿ߊ‫ޕ‬ԙ૕ᩰ඙ಽ೎ ᅧᆼਛᦼ߆ࠄᧃᦼߦ߅ߌࠆ  ㅳ㑆޽ߚࠅߩផᅑ૕㊀Ⴧട㊂ߩ⸳ቯߦߟ޿ߡ
࿖ౝߦ߅޿ߡ‫ޔ‬ᅧᆼᤨߩ․ቯߩᤨᦼߦ㒢ቯߒߚ૕㊀Ⴧട㊂ߦߟ޿ߡߩႎ๔ߪ޽ࠆ߽ߩ

ߩ‫ⷰߦ⊛ᤨ⚻ޔ‬ኤ‫⹏ޔ‬ଔߒߡ޿ߊߚ߼ߩ⋡቟ߣߥࠆㅳ޽ߚࠅߩ૕㊀Ⴧട㊂ߦߟ޿ߡߩႎ
๔ߪዋߥ޿‫ ޕ‬ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂ߦߟ޿ߡߪ‫ޔ‬ᅧᆼ 3 ࡩ᦬ᓟඨ߆ࠄ 9 ࡩ᦬ᓟඨ߹ߢ
߇ᐔဋ 250㨪350g/ㅳ‫ޔ‬ᅧᆼ 3 ࡩ᦬߹ߢߣ 0 ࡩ᦬߇ᐔဋ 00㨪200g/ㅳߣ޿߁ᴡ਄ߩႎ๔
߿ᅧᆼਛᦼߦ߅޿ߡ 0.35㨪0.45kg/ㅳ‫ޔ‬ᅧᆼᧃᦼߦ߅޿ߡ 0.25㨪0.45kg/ㅳߣ޿߁ฎ⾐22㧕ࠄߩႎ๔ 23㧕߇޽ࠆ‫ޕ‬৻ᣇ‫ޔ‬ᶏᄖߦ߅޿ߡߪ‫ޔ‬Institute of Medicine ߇ 990 ᐕߦ⊒⴫ߒߚ Nutrition During
Pregnancy ߢ‫ޔ‬ᅧᆼ೨ߩ૕ᩰࠍ 4 ඙ಽߣߒ‫ޔ‬඙ಽߏߣߦ✚૕㊀Ⴧട㊂ߩᦸ߹ߒ޿▸࿐ߣߣ߽ߦ‫ޔ‬ᅧᆼਛᦼએ㒠ߩ㧝ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂ࠍ␜ߒߡ޿ࠆ 24㧕‫ߚ߹ޕ‬㧝ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂ߦߟ޿ߡߪ‫ޔ‬Abrams ࠄߦࠃࠆ࿷⢝ㅳᢙ 4 ㅳ߹ߢߩೋᦼߦ߅ߌࠆ૕㊀Ⴧട㊂߇
㧙0.05kg‫ޔ‬5 ㅳ߆ࠄ 27 ㅳ߹ߢߩਛᦼߦ߅ߌࠆ૕㊀Ⴧട㊂߇ 5.7kg‫ࠆߌ߅ߦᦼᧃޔ‬૕㊀Ⴧ
ട㊂߇ 4.8kg ࠍߘࠇߙࠇਅ࿁ߞߚ႐วߩᐔဋ✚૕㊀Ⴧട㊂ߪ 6.2kg‫ఽޔ‬૕㊀ߪ 3070g ߢ޽ȝ 76 ȝ

ࠆ߇‫߽ࠇߕ޿ޔ‬਄࿁ߞߚ႐วߩᐔဋ✚૕㊀Ⴧട㊂ߪ 9.5kg‫ఽޔ‬૕㊀ߪ 3569g ߢ޽ߞߚ 25㧕
26㧕ߣ޿߁ႎ๔߿㕖ᅧᆼᤨߩ૕ᩰ඙ಽ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ߢޠ‬ਛᦼߦ߅ߌࠆ  ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂߇ 0.3kg/ㅳᧂḩߢߪ‫ޔ‬ሶችౝ⢝ఽ⊒⢒ㆃᑧ㧔IUGR㧕ߩ࡝ࠬࠢ߇ 2.68 ୚ߦ‫ޔ‬ਛᦼ෸߮ᧃᦼߦ߅ߌࠆ㧝ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂߇ 0.3kg/ㅳᧂḩߢߪ࡝ࠬࠢ߇ 2.07 ୚ߦߥࠆߣ޿߁ Strauss27㧕ߩႎ๔ߥߤ‫ޔ‬ฦ⒳ႎ๔ 25㧕㨪30㧕߇⷗ฃߌࠄࠇࠆ‫ޕ‬੹⥸‫ޔ‬ᅧᆼਛᦼ࡮ᧃᦼߘࠇߙࠇᦨૐ 2 ࿁ߪ૕㊀᷹ቯࠍⴕߞߡ޿ࠆᱜᦼ↥න⢝ಽᇂ 604
଀ߦߟ޿ߡ‫ޔ‬ᅧᆼਛᦼ࡮ᧃᦼߩ  ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂ߦߟ޿ߡᬌ⸛ߒߚ 26㧕‫⚿ߩߎޕ‬ᨐ‫ޔ‬‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ࠆߌ߅ߦޠ‬㧝ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂ߪ‫ޔ‬ਛᦼߢߪ 0.37r0.3 kg/ㅳ‫ ߪߢᦼᧃޔ‬0.38r0.3kg/ㅳ‫ޔ‬‫ࠆߌ߅ߦޠ߁ߟ߰ޟ‬㧝ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂ߪ‫ޔ‬ਛᦼ
ߢߪ 0.34r0.5kg/ㅳ‫ ߪߢᦼᧃޔ‬0.35r0. kg/ㅳ‫ޔ‬‫ޟ‬⢈ḩ‫ࠆߌ߅ߦޠ‬㧝ㅳ㑆޽ߚࠅߩ૕
㊀Ⴧട㊂ߪ‫ޔ‬ਛᦼߢߪ 0.2r0.2kg/ㅳ‫ ߪߢᦼᧃޔ‬0.29r0.5kg/ㅳߢ޽ࠅ‫ޔ‬‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫߽ᦨߢޠ‬㧝ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂߇ᄢ߈ߊ‫ޔ‬‫ޟ‬⢈ḩ‫ߢޠ‬ዋߥ޿௑ะߦ޽ߞߚ‫ޔߚ߹ޕ‬ᅧᆼਛᦼ߆ࠄᧃᦼߦ߅ߌࠆផᅑ૕㊀Ⴧട㊂߇ 0.3㨪0.5kg/ㅳߩ႐ว‫ޔ‬ᅧᆼోᦼ㑆ࠍㅢߒߡ
ߩផᅑ૕㊀Ⴧട㊂ߩ▸࿐ౝߢߩ૕㊀Ⴧട߇⷗ㄟ߹ࠇࠆ߇‫ޔ‬ᅧᆼਛᦼ߆ࠄᧃᦼߦ߅ߌࠆ㧝ㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂߇ 0.3kg/ㅳᧂḩߢ޽ߞߚ႐วߦߪ‫᦭ޔ‬ᗧߦ✚૕㊀Ⴧട㊂߇ዋߥ߆ߞߚ‫ޕ‬0.5kg/ㅳࠍ਄࿁ߞߚ႐วߩ࡝ࠬࠢߪ᣿ࠄ߆ߢߪߥ߆ߞߚ‫ޕ‬એ਄ߩ⚿ᨐࠍ߰߹߃‫ޔ‬૕ᩰ඙ಽ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ޠ‬‫ߩޠ߁ߟ߰ޟޔ‬႐ว‫ޔ‬ᅧᆼਛᦼ߆ࠄ
ᧃᦼߦ߅ߌࠆផᅑ૕㊀Ⴧട㊂ࠍ 0.3㨪0.5kg/ㅳߣߒ‫ޟޔ‬⢈ḩ‫ߩޠ‬႐วߪ‫♧ޔ‬ዩ∛߿㜞ⴊ࿶ߥߤߩၮ␆∔ᖚࠍ᦭ߒߡ޿ࠆ႐ว߇޽ࠅ‫ߩࠄࠇߎޔ‬ၮ␆∔ᖚߩ᦭ή߇⢝ఽ੍ᓟߦᄢ߈ߊ
ᓇ㗀ߔࠆน⢻ᕈ߇޽ࠆߚ߼‫ޔ‬୘೎ߦኻᔕߒߡ޿ߊߎߣߣߒߚ‫ޕ‬ߥ߅‫ޔ‬ᅧᆼೋᦼߦߟ޿ߡߪ૕㊀Ⴧടߦ㑐ߔࠆ೑↪น⢻ߥ࠺࡯࠲߇ਲߒ޿ߎߣߥߤ߆ࠄ‫ޔ‬ ㅳ㑆޽ߚࠅߩផᅑ૕㊀Ⴧട㊂ߩ⋡቟ࠍ␜ߒߡ޿ߥ޿ߚ߼‫⥃ߩߤߥࠅࠊߟޔ‬ᐥ⊛ߥ⁁ᴫࠍ〯߹߃‫ޔ‬୘೎ߦኻᔕߒߡ޿ߊ‫ޕ‬.

ö㧝㧕㕖ᅧᆼᤨߩ૕ᩰ෸߮ᅧᆼਛߩ૕㊀Ⴧട㊂ߦࠃߞߡ‫ޔ‬಴↢ఽߩ૕㊀෸߮ฦ⒳ಽᇂ⇣Ᏹߣߩ㑐ㅪࠍ⷗ߚ਄ߢ‫ޔ‬ฦ૕ᩰ඙ಽ೎ߦᅧᆼᦼߩᦸ߹ߒ޿૕㊀Ⴧട㊂ࠍ␜ߒߚ‫ޕ‬ߘߩ⚿ᨐ‫ޟޔ‬ᅧᆼోᦼ㑆ࠍㅢߒߡߩផᅑ૕㊀Ⴧട㊂‫ޔߪߡ޿߅ߦޠ‬૕ᩰ඙ಽ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕
‫ߩޠ‬႐ว‫ޔ‬ផᅑ૕㊀Ⴧട㊂ߪ 9㨪2kg‫ޔ‬‫ߩޠ߁ߟ߰ޟ‬႐ว‫ޔ‬7㨪2kg‫ޔ‬‫ޟ‬⢈ḩ‫ߩޠ‬႐ว‫ޔ‬୘೎ߦኻᔕߒߡ޿ߊߎߣߣߒ‫ޟޔ‬ᅧᆼਛᦼ߆ࠄᧃᦼߦ߅ߌࠆ  ㅳ㑆޽ߚࠅߩផᅑ૕㊀Ⴧട㊂‫ޔߪߡ޿߅ߦޠ‬૕ᩰ඙ಽ߇‫ޟ‬ૐ૕㊀㧔߿ߖ㧕‫ޠ‬෸߮‫ޠ߁ߟ߰ޟ‬ߩ႐ว‫ ޔ‬ㅳ㑆޽ߚࠅߩផᅑ૕㊀Ⴧട㊂ߪ 0.3㨪0.5kg/ㅳߣߒ‫ޔ‬‫ޟ‬⢈ḩ‫ߩޠ‬႐ว‫ޔ‬୘೎ߦኻᔕߒߡ޿ߊߎߣߣߒߚ‫ޕ‬

ȝ 77 ȝ

㧞㧕ߎࠇࠍᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕੍㒐ߩⷰὐ╬߆ࠄߎࠇ߹ߢ↪޿ࠄࠇߡ߈ߚ
ᜰ㊎╬ߣᲧセߒߚ߇‫ޔ‬ᄢ߈ߥᏅ⇣ࠍ↢ߓࠆ߽ߩߢߪߥ߆ߞߚ‫ޕ‬㧟㧕ฦ૕ᩰ඙ಽߦ߅ߌࠆᅧᆼᦼߩᦸ߹ߒ޿૕㊀Ⴧട㊂ߪ‫ޔ‬ᢥ₂⊛⎇ⓥ߆ߟ㓸࿅ࠍᝒ߃ߚ
⚿ᨐߢ޽ࠆߚ߼‫ߥ⊛৻↹ޔ‬ᜰዉߣߥࠄߥ޿ࠃ߁‫߽ߢ߹ߊ޽ޔ‬୘‫⁁ߩޘ‬ᘒࠍ߰߹߃ߚ
ኻᔕ߇ᦸ߹ࠇࠆ‫ޕ‬‫ޛ‬ෳ⠨ᢥ₂৻ⷩ‫ޜ‬㧕Sebire NJ, Jolly M, Harris J, Regan L, Robinson S. Is maternal underweight reallya risk factor for adverse pregnancy outcome? A population-based study in London.
BJOG. 200 ;08:6-66.
2㧕Ehrenberg HM, Dierker L, Milluzzi C, Mercer BM. Low maternal weight, failure to
thrive in pregnancy, and adverse pregnancy outcomes.Am J Obstet Gynecol.
2003;89:726-730.
3㧕Spinillo A, Capuzzo E, Piazzi G, Nicola S, Colonna L, Iasci A. Maternal high-riskfactors and severity of growth deficit in small for gestational age infants. Early
Hum Dev. 994 ;38:35-43.
4㧕Schieve LA, Cogswell ME, Scanlon KS, Perry G, Ferre C, Blackmore-Prince C, Yu SM,
Rosenberg D. Prepregnancy body mass index and pregnancy weight gain: associations
with preterm delivery. The NMIHS Collaborative Study Group. Obstet Gynecol.
2000;96:94-200.
5㧕Murakami M, et al. Prepregnancy body mass index as an important predictor ofperinatal outcomes in Japanese. Archives of Gynecology and Obstetrics 2005;
27:3-35
6㧕Edwards LE, Hellerstedt WL, Alton IR, Story M, Himes JH. Pregnancy complications
and birth outcomes in obese and normal-weight women: effects of gestational weightchange. Obstet Gynecol. 996;87:389-394.
7㧕Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight
and obese nulliparous women. Am J Public Health. 200;9:436-440.
8㧕Young TK, Woodmansee B. Factors that are associated with cesarean delivery in alarge private practice: the importance of prepregnancy body mass index and weightgain. Am J Obstet Gynecol. 2002;87:32-389㧕᧛↰⼾ᚑ, ઁ㧚⢈ḩᅧᇚߦ߅ߌࠆᅧᆼਛߩ૕㊀Ⴧട㊂ߣ↥⑼ว૬∝ߦߟ޿ߡ㧚Უᕈⴡ↢
985; 26:53-55
0㧕㜞ᯅ⧷ቁ,ศ↰ൎ⟤㧚ᅧᆼว૬∝ߩෂ㒾࿃ሶ-⢈ḩߣᅧᆼว૬∝㧚↥⑼ߣᇚੱ⑼ 998; 6:
793-799

ȝ 78 ȝ

㧕Rondo PH, Abbott R, Rodrigues LC, Tomkins AM. The influence of maternal nutritional
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3)਄↰ᐽᄦ‫ޔ‬ਣየ

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̂ ᧛↰⼾ᚑ㧚ᅧᆼਛ૕㊀Ⴧട㊂ߦᓇ㗀ࠍ෸߷ߔⷐ࿃ਗ߮ߦㆊ೾૕㊀Ⴧടᅧᇚߩ▤ℂߦ㑐ߔࠆ⎇ⓥ㧚᧲කᄢ⹹̂ ਛᨋᱜ㓶㧚‫ޟ‬ᅧᆼਛᲥ∝ߩᩕ㙃▤ℂᜰ㊎‫ޠ‬㧨ฦ⒳ኾ㐷ᆔຬળࠦ࡯࠽࡯㧪‫ޠ‬ᣣ↥ᇚ⹹㧔㧕0̂̂ Ἇᧄ⑲⟤㧔ಽᜂ⎇ⓥ⠪㧕㧦ᐔᚑᐕᐲෘ↢ഭ௛⑼ቇ⎇ⓥ⾌⵬ഥ㊄㧔ሶߤ߽ኅᐸ✚ว⎇ⓥ੐ᬺ㧕‫޿⧯ޟ‬ᅚᕈߩ㘩↢ᵴߪߎߩ߹߹ߢ⦟޿ߩ߆㧫ᰴ਎ઍߩஜᐽࠍ⠨ᘦߦ౉ࠇߚᩕ㙃ቇ࡮੍㒐කቇ⊛ᬌ⸛‫ޠ‬ႎ๔ᦠ㧔ਥછ⎇ⓥ⠪㧔ศᳰା↵㧕㧕
 *[VVGP('9GKIJVICKPKPRTGIPCPE[+P̌%NKPKECN2J[UKQNQI[KP1DUVGVTKEU̍$NCEMYGNN5EKGPEG1ZHQTF ᴡ਄ᓕᴦ㧚ᅧᆼ㨯ಽᇂ㨯↥ⶖ⚻ㆊߩᲣ૕૕㊀ߩᄌേߣߘߩ⥃ᐥ㧚↥ᇚੱ⑼ᴦ≮̂ ฎ⾐ජ㢬ሶઁ㧚ᅧᆼᤨᲣ૕૕㊀Ⴧട㊂ߦ㑐ߔࠆᬌ⸛㧚Უᕈⴡ↢̂
 +PUVKVWVGQH/GFKEKPG5WDEQOOKVVGGQP0WVTKVKQPCN5VCVWUCPF9GKIJV)CKPKP
2TGIPCPE[0WVTKVKQPFWTKPIRTGIPCPE[RCTVΣYGKIJVICKP0CVKQPCN#ECFGO[2TGUU9CUJKPIVQP&%
 #DTCOU$%CTOKEJCGN55GNXKP5(CEVQTUCUUQEKCVGFYKVJVJGRCVVGTPQHOCVGTPCNYGKIJVICKPFWTKPIRTGIPCPE[1DUVGV)[PGEQN̂
 #DTCOU$5GNXKP5/CVGTPCNYGKIJVICKPRCVVGTPCPFDKTVJYGKIJV1DUVGV)[PGEQN̂

ȝ 79 ȝ

27)Strauss RS and Dietz WH. Low maternal weight gain in the second or third trimester
increases the risk for intrauterine growth retardation. J Nutr 999; 29:988-993
28)Muscati SK, Gray-Donald K, Koski KG. Timing of weight gain during pregnancy:
promoting fetal growth and minimizing maternal weight retention. Int J Obes Relat
Metab Disord. 996; 20:526-532.
29)Hickey CA, Cliver SP, Goldenberg RL, Kohatsu J, Hoffman HJ. Prenatal weight gain,
term birth weight, and fetal growth retardation among high-risk multiparous black
and white women. Obstet Gynecol. 993;8:529-535.
30)Thame M, Osmond C, Bennett F, Wilks R, Forrester T.

Fetal growth is directly

related to maternal anthropometry and placental volume.
2004 ;58:894-900.

ȝ 7: ȝ

Eur J Clin Nutr.

ȝ 81 ȝÍ' Cl*Çb[ ÑÍ2Ñ¹Ì*޽ࠆY㧔Oሶ㧕ߦRߡߪ߹ࠆੱ߇‫ߩߘޔ‬Yߦ޽ߡߪ߹ࠄߥ޿ੱߦߴߡ૗޽ࠆࠍîߚߔᕈ߇޿߆ࠍ␜ߔᜰ

3ÑSGA*small-for-gestational ageÑÑ 4ÑLBW*low-birth weightÑ 5ÑHBW*high-birth weightÑ 6ÑSFD*small-for-dateÑ 7ÑLFD*large-for-dateÑ

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ߡ޿ߥ޿‫ޕ‬LBW 49.9%ߣᄙ
25.0ࠍ‫ޟ‬ᱜᏱ‫ޔޠ‬18.5 ‫ޟ‬no૕㊀Ⴧട‫ޕߚߒߣޠ‬ಾ3‫ޔ‬ᅧᆼ #ߩᅧᆼµ¶∛2ᅧᆼ∝㧔ᅧᆼ∝㧕2ಾÍ∝㧔ᅧᆼ∝㧕‫ޔ‬ᅧᆼµ¶∛‫ޔ‬32↥32ૐ಴↢૕㊀ఽഀว2↢ఽ౉Êߦኻߔࠆ¹Ì߼‫ޕ‬£ḩࠍ‫ߒߣޠߖ߿ޟ‬2↥‫౉ఽ↢ޔ‬ÊࠍLߒߚ‫ޕ‬
ࠍ\૕ᐕD2|}ಽ࿁y2ö2૕㊀Ⴧട㊂2k⢝¥yߢ⺞ߚ‫ޕ‬Ïߒߡ߼ߚߣߎࠈ‫ޔ‬૕ᩰಽ߇‫ޟ‬¥ߟ߁‫ޟޔߴߦޠ‬⢈ḩ‫ޠ‬ߢߪµ¶∛ߦኻߔࠆ¹ÌÍ2ߪ7.94(95%CIÍ'2.09ß30.'8㧕‫ޔ‬ᅧᆼ∝㧔ᅧᆼ∝㧕8.'3(3.78ß'7.49)‫ޔ‬ಾ32.42('.05ß5.58)ߢ޽ߞߚ‫ޕ‬૕ᩰಽ߇‫ߪߢޠߖ߿ޟ‬ૐ಴↢
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'.94('.02ß3.7')ߢ޽ߞߚ‫ޕ‬૕㊀Ⴧടಽ#ߦtPߦ⸃"ߒߚߣߎࠈ‫ޔ‬ᅧᆼߩBMIࠍ\૕ᐕD2|}ಽ࿁y2ö2k⢝¥yߢ⺞Ïߒߚวߪ !߇ߥ߆ߞߚ‫ޕ‬

Murakami M, et al. Prepregnancy body 633é
mass index as an important predictor ofperinatal
outcomesinJapanese.
Archives of Gynecology and Obstetrics
2005; 27':3''-3'5

஻⠨BMI'9.8 £ ḩ ߩ ࠍ ‫' ߿ ޟ‬¥[޽ߚࠅߩ૕㊀Ⴧട㊂ߣ↥ಽߣߩ !ࠍ '¥[޽ߚࠅߩ૕㊀Ⴧട㊂߇‫ޟ‬ૐ‫ߩޠ‬ว‫ޔ‬૕ᩰಽ߇‫ޟ‬¥ߟߖ‫ޔޠ‬BMI'9.8ß26.0 ࠍ ⸃"ߒߚ‫ޕ‬k⢝'4¥߆ࠄ28¥߹ߢߩᦼ[ߩ'¥[ ߁‫'ߢޠ‬¥[޽ߚࠅߩ૕㊀Ⴧട㊂߇‫ޟ‬ᐔ⊛‫ߚߞ޽ߢޠ‬วߣ‫ ޟ‬¥ ߟ ߁ ‫ ޔ ޠ‬BMI26.0ࠍ ޽ߚࠅߩ૕㊀Ⴧട㊂ࠍᅧᆼߩ૕ᩰಽ#ߦ LߒߡBMI'9.8£ḩߩ‫↥ߪߢޠߖ߿ޟ‬ಽߩ¹ÌÍ2ߪ6.7
C߃ࠆวࠍ‫ޟ‬⢈ḩ‫ ߣޠ‬¢಴‫ޕ‬ว∝߇޽ࠆวߪBᄖߒߚ‫'ޕ‬¥[޽ߚ ('.', 40.6)‫ޔ‬BMI'9.8ß26.0 ߩ૕ᩰಽ߇‫ޟ‬¥ߟ߁‫ߪߢޠ‬3.6
ࠅߩ૕㊀Ⴧട㊂߇0.23kg£ḩࠍ‫ޟ‬ૐ‫ ޔޠ‬0.23ß ('.6, 8.0) ‫ޔ‬BMI26.0ࠍC߃ࠆ‫ޟ‬⢈ḩ‫'ߪߢޠ‬.6 (0.7, 3.5)ߢ
ߒߚ‫ޕ‬
0.68kgࠍ‫ޟ‬ᐔ⊛‫ޔޠ‬0.68kg¤਄ࠍ‫ޕߚߞ޽ ߒߣޠޟ‬
ߚ‫ޕ‬

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Schieve LA, Cogswell ME, Scanlon KS, 3,5''é
Perry G, Ferre C, Blackmore-Prince C,
Yu SM, Rosenberg D. Prepregnancy bodymass index and pregnancy weight gain:
associations with preterm delivery. The
NMIHS Collaborative Study Group. Obstet
Gynecol. 2000;96:'94-200.

Spinillo A, Capuzzo E, Piazzi G, Nicola SGAఽ 36'3éߣኻ \૕ߩᅧᆼߩ૕㊀߇ \૕©OሶߣSGA 3࡝ࠬࠢߣߩ !ߩᬌ⸛ߦߪ‫ ޔ‬ᅧᆼߦ‫ޟ‬ૐ૕㊀‫ߩޠ‬ว‫ޔ‬SGA 3ߦኻߔࠆ¹ÌÍ2ߪ'.75Í'50kg£ḩࠍ‫ޟ‬ૐ૕㊀‫ ߣޠ‬ñࠬ¤¹ࠢ⸃"ࠍ↪޿ߚ‫ޕ‬S, Colonna L, Iasci A. Maternal high- ߣߒߡᱜᏱఽ784é
㧔958CI *'.'8ß2.59㧕‫'ޔ‬¥[޽ߚࠅߩ૕㊀Ⴧട㊂ߪ0.2kg
ߒߚ‫ޕ‬
risk
£ḩߢ2.86㧔958CIÍ'*'.86ß4.40㧕ߢ޽ߞߚ‫ޕ‬
factors and severity of growth deficit
in small for gestational age infants.
Early Hum Dev. '994 ;38:35-43.

BMI'9.8 £ ḩ ࠍ ‫ ߿ ޟ‬ᅧᆼߩ૕㊀߇'00Ë 㧔45.4kg㧕£ḩߢ ᅧᆼߩ૕㊀߇'00Ë 㧔45.4kg㧕£ḩߩૐ૕㊀⠪ߪ2.6%‫ޔ‬ߖ‫'ޔޠ‬9.8¤਄26.0¤ਅ ᅧᆼBMI߇‫ߩޠߖ߿ޟ‬ว‫ޔ‬ᅧᆼߩ'¥[޽ ‫'ߪޠߖ߿ޟ‬3.2%‫'ޔ‬¥[޽ߚࠅߩ૕㊀Ⴧട㊂ߩૐ1ߩ⠪ߪ44%ߢ
ࠍ‫ޟ‬¥ߟ߁‫ޔޠ‬27.0¤਄ ߚࠅߩ૕㊀Ⴧട㊂0.27kg£ḩߩวߩᅧᆼòÁ ޽ߞߚ‫ޕ‬ૐ૕㊀⠪ߢߪIUGR 2࡝ࠬࠢ߇2.3‫ޔ‬ૐ಴↢૕㊀ఽ࡝ࠬ
29.0¤ਅࠍ‫ޟ‬n૕㊀‫ࠍ! ߩߣ ޔޠ‬ᬌ⸛ߒߚ‫ޕ‬
ࠢ߇'.5‫ޔ‬ಾ࡝ࠬࠢߪ0.72ߢ޽ߞߚ‫ߪߢޠߖ߿ޟޕ‬29.0¤਄ࠍ‫ޟ‬⢈ḩ‫ߒߣޠ‬IUGR 2࡝ࠬࠢ߇'.67‫ޔ‬ૐ಴↢૕㊀ఽ࡝ࠬࠢ߇'.'3‫࡝↥ޔ‬ߚ‫ޕ‬ࠬࠢߪ'.22ߢ޽ߞߚ‫'ޕ‬¥[޽ߚࠅߩ૕㊀Ⴧട㊂߇ૐ޿⠪ߢߪIUGR 2࡝ࠬࠢ߇'.34‫ޔ‬ૐ಴↢૕㊀ఽ࡝ࠬࠢ߇'.22‫࡝↥ޔ‬
ࠬࠢߪ'.''ߢ޽ߞߚ‫ޕ‬ߩⷐ

Ehrenberg HM, Dierker L, Milluzzi C, '5,'96é
Mercer BM. Low maternal weight, failure
to thrive in pregnancy, and adverse
pregnancy outcomes.Am J Obstet Gynecol.
2003;'89:'726-'730.

ᣇߩⷐ

BMI20.0 £ ḩ ࠍ ‫ ߿ ޟ‬ᅧᆼว∝ߩ⁁ᴫ‫ޔ‬ಽu౉ߩªÆ‫ޔ‬ಽᓟ ‫ߢޠߖ߿ޟ‬ᄙ߆ߞߚߩߪᅧᇚ2‫ఽޔ↥ޔ‬૕㊀5Ð࡯"kߖ‫ޔޠ‬20.0¤਄25.0£ḩ \૕ว∝㧔ÕÖ∝‫ޔ‬಴‫ޔ‬ÆÇÈߥߤ㧕‫࡞ ޔ‬£ḩߩߢ޽ࠅ‫ޔ‬ᅧᆼµ¶∛‫ޔ‬ᅧᆼ∝㧔ᅧᆼࠍ‫ޟ‬¥ߟ߁‫ޕߚߒߣޠ‬↢ఽߩòÁ㧔NICU ' ߳ߩ౉Ê‫ఽޔ‬૕㊀‫∝ ߥ↥^ޔ‬㧕‫ޔ‬ಽu౉‫ޔ‬ಽᓟ಴ߥߤߪ‫ߢޠߖ߿ޟ‬wߥߤ㧕ߦߟ޿ߡ‫ޟߣޠߖ߿ޟޔ‬¥ߟ߁‫ޕߚߞ߆ ࠍޠ‬Lߒߚ‫ޕ‬⢈ḩቯၮḰ

Sebire NJ, Jolly M, Harris J, Regan L, 2'5,'05é
Robinson S. Is maternal underweight
really a risk factor for adverse
pregnancy outcome? A population-based
study in London. BJOG. 200' ;'08:6'-66.

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㕖 ᅧ ᆼ ᤨ BMI20.0 ᧂ ḩ‫ ޔ‬㕖ᅧᆼᤨߩ૕ᩰ‫ޔ‬૕㊀Ⴧട㊂ߣᏢ₺ಾ㐿₸ߩ㑐 ೋ↥ߩᏢ₺ಾ㐿₸ߪ2.76%ߢ޽ࠅ‫ఽޔ‬㗡㛽⋚ਇဋⴧ㧔CPD)ߦࠃ
ࠆᏢ₺ಾ㐿ߪ.7%ߢ޽ߞߚ‫ޕ‬BMI20.0ᧂḩ⟲ߦᲧߴ‫߽ᦨޔ‬BMI
20.0એ਄25.0ᧂḩ‫ޔ‬25.0 ㅪࠍ⸃ᨆߒߚ‫ޕ‬
એ਄30.0ᧂḩ‫ޔ‬30.0એ਄ߩ㜞޿⟲ߩᏢ₺ಾ㐿ߩࠝ࠶࠭Ყ۲2ߪ9.25(95%CI۲: 8.5㨪9.9)ߢ
ߩ4⟲ߦಽߌߚ‫ޕ‬޽ߞߚ‫ޕ‬BMI20.0ᧂḩ⟲ߢߪ૕㊀Ⴧട㊂߇3.6kgᧂḩߩ႐วߦᲧ

Young TK, Woodmansee B. Factors that න⢝ಽᇂ3,376଀
are associated with cesarean delivery
in alarge private practice: the importanceof prepregnancy body mass index andweight gain. Am J Obstet Gynecol.
2002;87:32-38

Wong W, Tang NL, Lau TK, Wong TW. A න⢝ಽᇂ908଀
new recommendation for maternal weightgain in Chinese women. J Am Diet Assoc.
2000;00:79-796.

 㧕 Rondo PH, Abbott R, Rodrigues LC,
Tomkins AM. The influence of maternal
nutritional facters on intrauterine
IUGR㧖2ఽ35଀ߣኻᾖ
growth retardation in Brazil. Paediatr ⟲ᱜᏱఽ32଀
Perinat Epidemiol. 997 ; : 52-66

૕㊀Ⴧട㊂
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IUGR㧖2ߩ࡝ࠬࠢߦᓇ㗀ߔࠆ㗄⋡ߣߒߡᲣ⢝ಽᇂ⋥ᓟߩ૕㊀
50.0kgએਅ‫ޔ‬༛ᾍ‫ޔ‬૕㊀Ⴧട7kgએਅ‫ޔ‬೨࿁LBW㧖4ఽ಴↥߇᛽಴ߐࠇߚ‫ޕ‬

BMI9.0 ᧂ ḩ ࠍ ‫ ߿ ޟ‬37㨪4ㅳߢ૕㊀2500g㨪4000gߩఽࠍಽᇂߒ‫ޔ‬ᅧ ‫⦟ޟ‬ᅢߥᅧᆼォᏫ⟲㨭ߩᐔဋ૕㊀Ⴧട㊂ߪ3.8r4.2kgߢ޽ߞߖ‫ޔޠ‬9.0એ਄23.5ᧂḩ ᆼว૬∝ߩ⷗ࠄࠇߥ߆ߞߚ‫⦟ޟ‬ᅢߥᅧᆼォᏫ⟲㨭 ߚ‫ޕ‬ೋᦼߦ߅ߌࠆㅳ㑆޽ߚࠅߩ૕㊀Ⴧട㊂ߪ0.06r0.35kg‫ޔ‬ਛࠍ‫ޔޠ߁ߟ߰ޟ‬23.5એ਄ 504଀ߩ࠺࡯࠲߆ࠄℂᗐ⊛ߥ૕㊀Ⴧട㊂ࠍ᳞߼ ᦼߦ߅޿ߡߪ0.5r0.33kg‫ ߪߡ޿߅ߦᦼᧃޔ‬0.45r 0.22kgߢߚ‫⦟ޟޕ‬ᅢߥᅧᆼォᏫ⟲㨭ߦ߅ߌࠆ૕㊀Ⴧട㊂ߩ ޽ߞߚ‫ߩޠߖ߿ޟޕ‬ℂᗐ૕㊀Ⴧട㊂ࠍ3.0㨪6.7kg‫ߟ߰ޟޔ‬ࠍ‫ޟ‬⢈ḩ‫ޕߚߒߣޠ‬25㨪75ࡄ࡯࠮ࡦ࠲ࠗ࡞୯ࠍ᳞߼‫ࠍࠇߎޔ‬ၮḰߣ ߁‫ࠍޠ‬.0㨪6.4kg‫ޟޔ‬⢈ḩ‫ࠍޠ‬7.㨪4.4kgߣߒߚߣߎࠈ‫ޔ‬૕ߒߚ‫ޕ‬㊀Ⴧട㊂߇ਇ⿷ߩ႐วߩLBW㧖4ߩࠝ࠶࠭Ყ۲2ߪ2.76‫ޔ‬૕㊀Ⴧട㊂
۲2߇ㆊ೾ߩ႐วߩಽᇂᤨ੺౉ߩࠝ࠶࠭Ყ ߪ2.6ߢ޽ߞߚ‫ޕ‬

BMI20.0ᧂḩࠍ‫߿ޟ‬ߖ‫ޔޠ‬20.0એ਄25.0ᧂḩࠍ‫ޔޠ߁ߟ߰ޟ‬25.0એ਄ IUGR㧖2ߦ㑐ㅪߔࠆ3㗄⋡ߦߟ޿ߡᄙᄌ㊂ࡠࠫࠬ
30.0ᧂḩࠍ‫ޟ‬ㆊ૕㊀‫⸃ࠢ࠶ࠖ࠹ ޔޠ‬ᨆࠍⴕߞߚ‫ޕ‬
30.0એ਄ࠍ‫ޟ‬⢈ḩ‫ߒߣޠ‬ߚ‫ޕ‬ߪ3.6ߢ޽ߞߚ‫ޕ‬

3.8r4.2kg࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕࡮ಾㄼᵹ↥࡮ಾㄼᣧ↥ 2.54㧕‫ޔ‬ಾㄼᣧ↥߽.60㧔.8㨪2.7㧕ߢ޽ߞߚ‫ޕ‬㕖ᅧᆼᤨߩ ᐔဋ૕㊀Ⴧട㊂ߩ࡝ࠬࠢࠍᲧセߒߚ‫ޕ‬
BMI߇26.0એ਄ߢᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕ߩࠝ࠶࠭Ყ۲2 ߪ9.9kg

㜞ᯅ⧷ቁ,ศ↰ൎ⟤㧚ᅧᆼว૬∝ߩෂ㒾࿃ሶ ḩᦼ↥න⢝ಽᇂ550଀ BMI8.0 એ ਄ 24.0 ᧂ ḩ ࠍ ૕㊀Ⴧട㊂ࠍᅧᆼᦼ㑆280ᣣߦ឵▚ߒ‫ޔ‬0kgᧂ ᐔဋ૕㊀Ⴧട㊂ߪ9.9kgߢ޽ߞߚ‫ޕ‬ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ‫ޟ‬ᱜᏱ‫ޕߚߒߣ⟲ޠ‬ḩ‫ޔ‬0㨪2kg‫ޔ‬2㨪4㧘4㨪6kg‫ޔ‬6kgએ਄ߩ5 ∝㧕ߪ4kgએ਄ߢࠝ࠶࠭Ყ ۲2.9㧔.2㨪3.00㧕‫ޔ‬6kgએ਄ߢ- ⢈ḩߣᅧᆼว ૬∝㧚↥⑼ߣ ᇚੱ ⑼ 998;⟲ߦಽߌ‫ޔ‬0㨪2kgࠍၮḰߦᅧᇚ⽺ⴊ㨯ᅧᆼ㜞ⴊ 2.65(.39㨪5.05)ߢ޽ࠅ‫ޔ‬ಾㄼᵹ↥ߪ0kgᧂḩߢ.63㧔.04㨪
6: 793-799⢈ḩߢว૬∝ߩߥ޿appropriate-for-datesఽࠍ಴↥ߒߚ߽ߩߢߪ
ᅧᆼ26ㅳ߹ߢߩ૕㊀Ⴧട㊂߇3.3r2.0kg‫ޔ‬ᅧᆼਛߩ૕㊀Ⴧട㊂
߇6.7r2.7kgߢ޽ߞߚߎߣ߆ࠄ‫ޔ‬26ㅳ߹ߢߩჇട㊂ࠍ4kg‫ޔ‬ᅧᆼోᦼࠍㅢߓߡߪ7kgࠍផᅑߒߚ‫ޕ‬᧛↰⼾ᚑ, ઁ㧚⢈ḩᅧᇚߦ߅ߌࠆᅧᆼਛߩ ⢈ḩᅧᇚ59 ଀ߣᮡḰ 㕖 ᅧ ᆼ ᤨ ߩ Broca ᜰ ᢙ ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕࡮heavy-for- ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕ߩഀวߪ‫ޟ‬⢈ḩ‫ޠ‬30.5%‫ޟޔ‬ᮡ
+20%એ਄ࠍ‫ޟ‬⢈ḩ‫ ޔޠ‬datesఽഀว࡮ᏂᄢఽഀวࠍᲧセߒߚ‫ޕ‬Ḱ‫ޠ‬4.1%‫ޔ‬heavy-for-datesఽ ߩ ഀ ว ߪ ‫ޟ‬⢈ ḩ‫ޠ‬18.6%‫ ޟ ޔ‬ᮡ૕㊀Ⴧട㊂ߣ↥⑼ว૬∝ߦߟ޿ߡ㧚Უᕈⴡ ૕ဳ238଀
↢
r 10% ࠍ ‫ ޟ‬ᮡ Ḱ ‫ߒ ߣ ޠ‬Ḱ‫ޠ‬9.7%‫ޔ‬Ꮒᄢఽߩഀวߪ‫ޟ‬⢈ḩ‫ޠ‬8.47%‫ޟޔ‬ᮡḰ‫ޠ‬1.78%ߢ
985;
26:53-55ߚ‫ޕ‬޽ߞߚ‫ޕ‬Ꮲ₺ಾ㐿₸ߪ‫ޟ‬⢈ḩ‫ޠ‬20.3%‫ޟޔ‬ᮡḰ‫ޠ‬㧢%ߢ޽ߞߚ‫ޕ‬ߴ‫ޔ‬6kgࠍ⿥߃ࠆߣᏢ₺ಾ㐿ߩࠝ࠶࠭Ყ۲2ߪ3.8㧔95%CI ۲:3㨪
4.6㧕‫ޔ‬BMI20.0એ਄25.0ᧂḩ⟲ߢߪ.85㧔95%CI۲: .63㨪2.06)ߢ޽ࠅ‫ߩઁޔ‬2⟲ߢߪ૕㊀Ⴧട㊂ߣᏢ₺ಾ㐿₸ߣߩ㑆ߦ㑐ㅪߪ⹺߼ࠄࠇߥ߆ߞߚ‫ޕ‬

BMI20.0 ᧂ ḩ ࠍ ‫ ߿ ޟ‬LBW㧖4‫ޔ‬HBW㧖5‫ޔ‬SFD㧖6‫ ޔ‬ᣧ↥‫ޔ‬Ꮲ₺ಾ㐿‫ఽ੃ޔ‬ᱫ ‫ߣޠߖ߿ޟ‬Ყߴ‫ޟޔ‬⢈ḩ‫ޟߣޠ‬ㆊ૕㊀‫♧ߪߢޠ‬ዩ∛‫ޔ‬Ꮲ₺ಾߖ‫ޔޠ‬20.0એ਄24.9એਅ ੢‫ޔ‬ᅧᆼ♧ዩ∛‫ޔ‬ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ 㐿‫ޔ‬HBW㧖5‫ఽ੃ޔ‬ᱫ੢‫ޔ‬ᅧᆼ㜞ⴊ࿶∝୥⟲㧔ᅧᆼਛᲥ∝㧕ߩ࡝ࠬࠍ‫ޔޠ߁ߟ߰ޟ‬25.0એ਄ ∝㧕߳ߩ㕖ᅧᆼᤨߩ૕ᩰ೎ߦ࡝ࠬࠢࠍ‫ޔ‬Უ૕ᐕ ࠢ߇᦭ᗧߦ㜞߆ߞߚ‫ޕ‬29.9એਅࠍ‫ޟ‬ㆊ૕㊀‫ ޔޠ‬㦂࡮༛ᾍ㨯ᢎ⢒࡟ࡌ࡞࡮⚿ᇕߩ᦭ή㨯ᅧᇚஜ⸻ฃ
30.0એ਄ࠍ‫ޟ‬⢈ḩ‫ߦޠ‬ಽ ⸻㐿ᆎᤨᦼ࡮ஜᐽ଻㒾ߩ⒳㘃࡮૕㊀Ⴧട㊂ߢ⺞㘃ߒߚ‫ޕ‬
ᢛߒ‫ޔ‬ᬌ⸛ߒߚ‫ޕ‬

BaetenJM, Bukusi EA, Lambe M. 96,80଀
Pregnancy complications and outcomesamong overweight and obese nulliparous
women. Am J Public Health. 200;9:436440.

Edwards LE, Hellerstedt WL, Alton IR, 㕖 ᅧ ᆼ ᤨ ૕ ᩰ ߇ ‫ ޟ‬⢈ 㕖 ᅧ ᆼ ᤨ ߩ BMI9.0 એ਄ න⢝↢ఽࠍಽᇂߒߚ‫ޟ‬⢈ḩ‫ߦ⟲ޠ‬ኻߒ‫ੱޔ‬⒳࡮ ‫ޟ‬⢈ḩ‫ߪߢ⟲ޠ‬૕㊀Ⴧട㊂ߣᅧᆼ♧ዩ∛߿ᅧᆼ㜞ⴊ࿶ߩ⊒∝‫ޔ‬
Story
M,
Himes
JH.
Pregnancy ḩ‫ߩޠ‬⠪ 683଀ߣ‫ ߰ޟ‬26.0ᧂḩࠍ‫ ޔޠ߁ߟ߰ޟ‬ಽᇂᣣ࡮ᐕ㦂᏷࡮ᣢᓔಽᇂ࿁ᢙߢࡑ࠶࠴ࡦࠣߐ Ꮲ₺ಾ㐿₸ߣߩ㑐ㅪߪ⹺߼ࠄࠇߥ߆ߞߚ‫ޕ‬ᅧᆼਛߦ߅ߌࠆ૕㊀
29.0એ਄ࠍ⿥߃ߚ႐วࠍ ߖߚ‫ࠍ⟲ޠ߁ߟ߰ޟ‬ኻᾖߣߒߡㆬᛯߒߚ‫ ߩఽޕ‬Ⴧട߇⷗ࠄࠇߥ߆ߞߚࠅ‫ߪ޿ࠆ޽ޔ‬ᷫዋߒߚ‫ޟ‬⢈ḩ‫ޠ‬ᅚᕈߢ
complications and birth outcomes in ߟ߁‫ߩޠ‬⠪ 660଀‫ޟ‬⢈ḩ‫ޕߚߒߣޠ‬LBW/SGA 㧖 4 㧖 3 㗫 ᐲ ‫ ޔ‬3000 㨓 ᧂ ḩ ߩ ఽ ߩ ഀ ว ‫ޔߪ ޔ‬7㨪.5kgჇടߒߚᅚᕈߣᲧߴ‫ޔ‬SGA㧖3ఽࠍಽᇂߔࠆ࡝ࠬࠢ
obese and normal-weight women: effects
4000gࠍ⿥߃ࠆఽߩഀวߦߟ޿ߡᲧセߒߚ‫ޕ‬߇ࠝ࠶࠭Ყ۲2ߢ2.9୚ߢ޽ߞߚ‫ޕ‬of gestational weight change. Obstet
Gynecol. 996;87:389-394.

ᒁ↪ᢥ₂

۲ Cl㧦ା㗬඙㑆 ‫ޓ‬۲2‫࠭࠶ࠝޓ‬Ყ㧦޽ࠆ᧦ઙ㧔࿃ሶ㧕ߦᒰߡߪ߹ࠆੱ߇‫᧦ߩߘޔ‬ઙߦ޽ߡߪ߹ࠄߥ޿ੱߦᲧߴߡ૗୚޽ࠆ⚿ᨐࠍ᧪ߚߔน⢻ᕈ߇㜞޿߆ࠍ␜ߔᜰᮡ

㧖 NICU㧦ᣂ↢ఽ㓸ਛᴦ≮ቶ‫ޓ‬㧖2‫ޓ‬IUGR㧦ሶችౝ⢝ఽ⊒⢒ㆃᑧ‫ޓޓ‬㧖3‫ޓ‬SGA㧦small-for-gestational age‫ޓޓ‬㧖4‫ޓ‬LBW㧦low-birth weight‫ޓ‬㧖5‫ޓ‬HBW㧦high-birth weight‫ޓ‬㧖6‫ޓ‬SFD㧦small-for-date‫ޓ‬㧖7‫ޓ‬LFD㧦large-for-date‫ޓ‬

2



0

9

8

7

6

ᢥ₂
⇟ภ

㧖4

㧖5

LBW 6.2%ߦኻߒ‫ޔ‬HBW ߇
2.7% ߣ ᣣ ᧄ ੱ ߩ ಽ Ꮣ ߦ ㄭ޿‫ޕ‬‫ޟ‬⢈ḩ‫ޟߣޠ‬ᮡḰ‫߅ߦ⟲ޠ‬ߌࠆᐕ㦂࡮り㐳࡮⚻↥࿁ᢙߩ⸥タߥߒ‫ޕ‬஻⠨ȝ 83 ȝ

ኻ⽎

ᣇߩⷐ

ߩⷐ

ߥߒ

߇

4ÑLBW*low-birth weightÑ 5ÑHBW*high-birth weightÑ 6ÑSFD*small-for-dateÑ 7ÑLFD*large-for-dateÑ

Í' Cl*Çb[ ÑÍ2Ñ¹Ì*޽ࠆY㧔Oሶ㧕ߦRߡߪ߹ࠆੱ߇‫ߩߘޔ‬Yߦ޽ߡߪ߹ࠄߥ޿ੱߦߴߡ૗޽ࠆࠍîߚߔᕈ߇޿߆ࠍ␜ߔᜰ

3ÑSGA*small-for-gestational ageÑÑ

ᦼߩ૕㊀Ⴧട㊂ಽ#ߩLߩ㓙‫ߩⷫ\ޔ‬ᅧᆼߩ૕ᩰ߇⠨ߐࠇߡ޿ߥ
޿‫ޕ‬ᐔ૕㊀Ⴧട㊂ߪਇ~\ⷫߩᅧᆼߩ૕ᩰߣᅧ
ᆼߩ૕㊀Ⴧട㊂ߩ !߇
⠨ߐࠇߡ޿ߥ޿‫ޕ‬5↥⑼ᄖîߢቯᦼ⊛૕㊀ ᅧᆼߩBrocaᜰyÖ ૕㊀Ⴧട㊂2ఽ૕㊀2ëµ⇣Ᏹ2¨ಽ2 ᅧᆼᦼߩ૕㊀Ⴧടߦߟ޿ߡߪ߿ߖêߢ27.9%‫ޔ‬¥ߣࠅêߢ8.8%
é ࡯ࠍฃߌߚᅧᇚ 10%ࠍ ‫ ޟ‬A  ‫ ޔ ޠ‬+10 ß ಾ2ಽ ಴ ㊂2 ᅧᆼ  ∝  ߇noê‫ޕ‬uᦼߩ૕㊀Ⴧടߦߟ޿ߡߪ‫ߖ߿ޔ‬êߢ25.0%‫ޔ‬¥ߣࠅ
53'é
20%ࠍ‫ޟ‬B‫ޔޠ‬+20%¤ 㧔ᅧᆼ∝㧕ࠍLߒߚ‫ޕ‬ᅧᆼ26¥⋡ߩ૕㊀ êߢ'3.9%߇noê‫ޟߢᦼޕ‬no૕㊀Ⴧട‫ఽߢޠ‬૕㊀3500g
Ⴧടࠍ4.9kg¤ਅࠍ‫ޟ‬nw૕㊀Ⴧട‫ޔޠ‬8.'kg ¤਄ߪ33.7%‫ޟޔ‬nw૕㊀Ⴧട‫'ߢޠ‬0.3%ߢ޽ߞߚ‫ޕ‬ëµ⇣਄ ࠍ ‫ ޟ‬C  ‫  ޔ ޠ‬10 ß¤਄ࠍ‫ޟ‬no૕㊀Ⴧട‫ޕߚߒߣޠ‬ᅧᆼuᦼߢ Ᏹ2¨ಽ2ಾ2ಽ಴㊂2ᅧᆼ∝
20%ࠍ‫ޟ‬D‫ޔޠ‬20% ߪ‫ޔ‬8.0kg¤ਅࠍ‫ޟ‬nw૕㊀Ⴧട‫'ޔޠ‬5.'kg¤ 㧔ᅧᆼ∝㧕ߩߔߴߡߦ߅޿ߡᦼߩ‫ޟ‬no૕㊀Ⴧട‫ߢޠ‬¤ਅࠍ‫ޟ‬E‫ ޕߚߒߣޠ‬਄ࠍ‫ޟ‬no૕㊀Ⴧട‫ޕߚߒߣޠ‬߇߆ߞߚ‫ޕ‬BCࠍ‫ޟ‬¥ߣࠅê‫ޔޠ‬DEࠍ‫ߖ߿ޟ‬ê‫ޔޠ‬A
ࠍ‫ޟ‬Ḱê‫ޕߚߒߣޠ‬߆ߞߚ‫ޕ‬಴↢૕㊀ߪ‫⊛∛ޟ‬⢈ḩ‫ޟ߿ޠ‬⢈ḩ‫ޠߖ߿ޟߢޠ‬ࠃࠅߊ‫ޟޔ‬no૕㊀Ⴧട‫ޟߢޠ‬nw૕㊀Ⴧട‫ࠅࠃޠ‬߆ߞߚ‫ޕ‬ ᅧ ᆼ  ߩ Broca ᜰ y ᅧᆼᦼ[ߩ૕㊀Ⴧട㊂ࠍ6.8kg¤ਅࠍ‫ޟ‬nw ‫ ⊛ ∛ ޟ‬⢈ ḩ ‫ ߪ ޠ‬7.8%‫ޟ ޔ‬⢈ ḩ‫' ߪ ޠ‬6.7%‫ߪ ޠߖ ߿ޟ ޔ‬+20% ¤ ਄ ࠍ ‫ ⊛ ∛ ޟ‬⢈ ૕ ㊀ Ⴧ ട ‫ ޔ  ޠ‬6.8 ß '8.5kg ࠍ ‫ ޟ‬ኻ  ‫' ޔ  ޠ‬3.9%ߢ޽ߞߚ‫⊛∛ޟߪޠߖ߿ޟޕ‬⢈ḩ‫߽ࠅࠃޠ‬ᐔ૕㊀Ⴧḩ‫ޔޠ‬+10ß20%ࠍ‫ޟ‬⢈ '8.5kg¤਄ࠍ‫ޟ‬no૕㊀Ⴧട‫ޔߒߣޠ‬ಽ ട㊂߇ᄙ߆ߞߚ‫ޟޕ‬no૕㊀Ⴧട‫ߪޠ‬5.8%‫ޟޔ‬nw૕㊀Ⴧട‫ߪޠ‬4.8%ߢ޽ߞߚ‫ޕ‬s↥ߩ‫⊛∛ޟ‬⢈ḩ‫ߪߢޠ‬ಽ[߇[‫ޔ‬ಾ3‫ఽޔ‬૕㊀ࠍLߒߚ‫ޕ‬ḩ ‫ ޔ  ޠ‬Ö 10% ࠍ ‫ ޟ‬ᱜ߆ߞߚ߇‫ޕߚߞ߆ߥ߇}ߪߢ↥⚻ޔ‬s↥ߩ‫ޟ‬no૕㊀Ⴧട‫ޠ‬Ᏹ ‫  ޔ  ޠ‬10% £ ḩ ࠍߢಽ[߇ ߆ߞߚ߇‫ޕߚߞ߆ߥ߇}ߪߢ↥⚻ޔ‬ಾ‫ޕߚߒߣޠߖ߿ޟ‬3ߪ‫⊛∛ޟ‬⢈ḩ‫ޟߣޠ‬⢈ḩ‫ޟߚ߹ޔޠ‬no૕㊀Ⴧട‫ߢޠ‬

29.0¤਄ࠍ‫ޟ‬⢈ḩ‫ ߒߣޠ‬1‫ఽ↢ޔ‬ã↢ߩªÆ‫ޔ‬äåÉ↥‫ޔ‬nᦼ↥ߥߤߚ‫ޕ‬ߩ⇣Ᏹߣߩ !ࠍ⸃"ߒߚ‫ޕ‬

LBW 42.3%ߦኻߒ‫ޔ‬HBW'2.2%ߣᄙ޿‫ޕ‬

૕㊀Ⴧട㊂ߩwߥ߆ߞߚ2
ߢߪ7ߩߦߴߡᅧ
ᆼߩ૕㊀߇ªqߦ㊀޿‫ޕ‬ߒ߆߽ᅧᆼsᦼ߆ࠄ࡝࡯³åࠍฃߌߡ޿ߚ⠪߇߹ࠇߡ޿ࠆ‫ޕ‬2ÑIUGR*ሶúౝ⢝ఽ⊒xÑÑᚑᅧᆼ૕㊀Ⴧട㊂ߦᓇ㗀ࠍ෸
ߔⷐO¹߮ߦno૕㊀Ⴧടᅧᇚߩ▤Ìߦߔࠆ⎇ⓥºකᄢ¦Ñ'984; 42:355-368

>9 n\8d " #  $% &e f Bg
Mb 9hi<M")bnLjk5%lm(no$"$&

஻⠨‫ޟ‬⢈ḩߣ߿ߖߩቯZ‫ޟ ޠ‬⢈ḩ‫ޠ‬ᅧᇚࠍ૕㊀Ⴧട㊂#ߦ4㧔0kg£ḩ‫ޔ‬0 4[ߢಾ3ߦߪ}߇⷗ࠄࠇߥ߆ߞߚ‫ޕ‬૕㊀Ⴧടࠍ߈ߚߐ
(1986) ߢ  ᅧ ᆼ  ߩ  ß5kg‫ޔ‬5ß10kg‫ޔ‬10kg¤਄㧕ߦಽߌ‫ޔ‬ಾ ߥ߆ߞߚ㧔N=14㧕ߢߪ‫ޔ‬çሶಽ߇ߺࠄࠇߥ߆ߞߚ‫ޕ‬ಽ
2૕㊀2ᐕD߆ࠄ75% 32çሶಽ32 ಽ ಴ ㊂ 2ಽ  [2 ಴㊂ߪ૕㊀Ⴧട㊂߇ᄙ߆ߞߚ2ߟߩߢ7ߩ2ߦߴ‫ޔ‬ᄙ¤਄ߩ߽ߩࠍ‫ޟ‬⢈ḩ‫ ߣޠ‬heavy-for-datesఽഀวࠍLߒߚ‫ޕ‬߆ߞߚ‫ޕ‬ᐔಽ[ߪs↥ᇚߢߪ૕㊀Ⴧട߇wߥ޿ߤèቯ‫ޕ‬߆ߞߚ߇‫↥⚻ޔ‬ᇚߢߪ}߇ߥ߆ߞߚ‫ޕ‬૕㊀Ⴧടࠍ߈ߚߐߥ߆ߞ
ߚߢߪheavy-for-datesఽߪߺࠄࠇߥ߆ߞߚ‫ޕ‬µ,, 7⢈ḩᅧᇚߩᩕ㙃▤Ìߦ ߔࠆ ‫ޟ‬⢈ḩ‫ޠ‬ᅧᇚ151éၮ ¶ ⊛ ‫ ⎇ ⊛ ¸ · ޔ‬ⓥ ᣣ↥ᇚ¦
229-236.

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ᅧᆼsᦼ߆ࠄÚ᦬'࿁Òx∛Êᄖîߢ૕㊀3ቯࠍ ᅧᆼ4Õ᦬߹ߢߪᅧᆼߩ૕㊀ߣߴ‫ߣޔ‬Ïߤᄌൻ߇ߺࠄࠇ LFD 7ఽࠍಽߒ  ߩs࡯k߇ߥ޿ߚ߼‫ޔ‬ⴕ޿‫ޔ‬ḩᦼ⢝↢ఽࠍ8ߚéߦߟ޿ߡᅧᆼ᦬# ߥ߆ߞߚ‫ޕ‬40¥ߢߩ૕㊀Ⴧട㊂ߩᐔߪ9.99kgߢ޽ࠅ‫ޔ‬಴↢ ߚ\ⷫߩᐔ૕ BMIਇ~‫ޕ‬
૕㊀ჇടÓÔࠍ_ᚑߒߚ‫ޕ‬૕㊀ჇടߣLFD/SFD 7 ߩఽ૕㊀ߪ3225.6Ö380.5gߢ޽ߞߚ‫ޕ‬LFD 7ఽࠍಽߒߚ\ⷫߩ ㊀ Ⴧ ട ㊂ ߪ
6ߣߩ !‫⇣⑼↥ޔ‬Ᏹߣߩ !ߦߟ޿ߡ⸃"ࠍ ૕㊀Ⴧട㊂ߩᐔߪ9.96kgߢ޽ࠅ‫ޔ‬SFD 6 ఽߢߪ9.00kgߢ޽ߞ 9.96kg‫ޔ‬SFD 6ఽߒߚ‫ޕ‬ߚ‫ޕ‬૕㊀Ⴧട㊂߇'4.64kg㧔ᐔ+'.5SD㧕ࠍC߃ࠆ⠪ߢߪ೨ᦼ× ߢ ߪ 9.00kg ߢ/2ᅧᆼ∝㧔ᅧᆼ∝㧕ߩ߇߆ߞߚ߇‫ޔ‬ಽ ޽ߞߚ‫ޕ‬[߿಴㊂ߣ૕㊀Ⴧട㊂ߩ !ߪ⹺߼ࠄࠇߥ߆ߞߚ‫ޕ‬$½ L)§jw<MLb,%n\I8
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Johnson JW, Longmate JA, Frentzen B. 38 ¥ ¤ ) ߩ ಽ  é BMI'9.8 £ ḩ ࠍ ‫ߩⷫ\ ߿ ޟ‬ᅧᆼߩ૕ᩰ#߿૕㊀Ⴧട㊂ߣLBW 4‫ ޔ‬૕㊀Ⴧട㊂ᄢ('7kg¤਄㧕ߣ !ߒߡ޿ߚߩߪHBW 5‫ޔ‬ÛÜߖ‫'ޔޠ‬9.8¤਄26.0¤ਅ HBW 5(4000g¤਄㧕‫ޔ‬Ø/ÙÚ‫'ޔ‬2㧡ಽᓟ¢ ಾ‫ޔ‬⢝ఽ ß⇣Ᏹ‫ޔ‬Ø/ÙÚߢ޽ߞߚ‫ޕ‬
Excessive maternal weight and pregnancy 3,'9'éࠍ‫ޟ‬¥ߟ߁‫ޔޠ‬27.0¤਄ ࡯࡞ࠬî‫ޔ‬ÛÜಾ‫ޔ‬ÝÞ¢ㅴ‫ޔ‬ಽ
outcome.
Am
J
ObstetGynecol.
29.0¤ਅࠍ‫ޟ‬n૕㊀‫ ޔޠ‬ㅴⴕߩ⇣Ᏹ‫ޔ‬⢝ఽ ßߩ⇣Ᏹ‫ޔ‬àáâHߩૐ'992;'67:353-70; discussion 370-372.

§,¨©ªሶᅧᇚߩ૕㊀Ⴧടߣߘߩᅧ 806ಽéᆼJಽJ⢝ఽ⊒x߳ߩᓇ㗀ߦߟ޿ߡ↥ᇚ
ੱ⑼≮ '975; 3':646-655

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H࿖ߢ'980ß89ᐕߦႎ๔ߐࠇߚ'0ߩ⎇ⓥ ᅧᆼᦼ߆ࠄuᦼߩ'¥[޽ߚࠅߩ૕㊀Ⴧ߆ࠄ‫ޔ‬ᅧᆼߩ'¥[޽ߚࠅߩ૕㊀Ⴧട㊂ ട ㊂ ߪ 0.3 ß 0.7kg ߢ ޽ ߞ ߚ ‫ ޕ‬⢈ ḩ ⠪ ߢࠍ߼ߚ‫ޕ‬ߪ‫ޔ‬૕㊀Ⴧടߩêࠄߟ߈߇ᄢ߈߆ߞߚ‫ޕ‬

Í' Cl*Çb[ ÑÍ2Ñ¹Ì*޽ࠆY㧔Oሶ㧕ߦRߡߪ߹ࠆੱ߇‫ߩߘޔ‬Yߦ޽ߡߪ߹ࠄߥ޿ੱߦߴߡ૗޽ࠆࠍîߚߔᕈ߇޿߆ࠍ␜ߔᜰ

0.563Ö
0.236(g)಴↢૕㊀4 ߩs࡯k߇ߥ ޿ ߚ ߼ BMI ਇ~‫ޕ‬ ߩs࡯k߇ߥ ޿ ߚ ߼ BMI ਇ~‫ޕ‬

LBW 36.2% ߦ ኻߒ ‫ ޔ‬HBW 5 ߇
2.7% ߣ ᣣ  ੱߩಽߦㄭ޿‫ޕ‬஻⠨7ÑLFD*large-for-dateÑ

0.5'8Ö
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ᅧᆼuᦼ
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0.'69Ö
0.268(g)5ÑHBW*high-birth weightÑ

Abrams B, Carmichael S, Selvin S.  ⢝ ಽ  BMI'9.8£ḩࠍ‫ ߿ޟ‬ᅧᆼᦼ෸߮uᦼߦૐ2࿁ߟ૕㊀3ቯ ‫ޟߣޠߖ߿ޟ‬¥ߟ߁‫ޠ‬૕êߩᅚᕈߢߪ‫ޔ‬
Factors
associatedwiththe '0,4'8é ߖ ‫' ޔ ޠ‬9.8 ¤ ਄ ࠍฃߌߚኻ⽎⠪ߦߟ޿ߡ‫ޔ‬ᅧᇚஜ¦ߩ ᅧᆼᦼߢ'¥[޽ߚࠅߩ૕㊀Ⴧട㊂߇
pattern of maternal
weight gain
26.0 ¤ ਅ ࠍ ‫ ޟ‬¥ߟ ฦ3ቯ૕㊀1ࠍ↪޿ߚ࿁Áಽ"ߦࠃࠅ ߽ߊ‫ޔ‬⢈ḩ⠪ߢߪuᦼߢ߆ߞߚ‫ޕ‬s߁ ‫ ޔ ޠ‬26.0 ¤ ਄ ᅧᆼᦼ෸߮uᦼߩ'¥[޽ߚࠅߩ૕㊀Ⴧ ᦼߩ'¥[޽ߚࠅߩ૕㊀Ⴧട㊂ߪᐕDߣõ
during pregnancy. Obstet Gynecol.
29.0 ¤ ਅ ࠍ ‫ ޟ‬n૕ ട㊂ࠍ߼ߚ‫ޕ‬sᦼߩ'¥[޽ߚࠅߩ૕㊀  ࠍ ␜ ߒ ߚ ߇ ‫  ߪ ߢ ᦼ  ޔ‬ᅧ ᆼ  ߩ'995; 86:'70-'76.
㊀ ‫ ޔ ޠ‬29.0 ¤ ਄ࠍ Ⴧട㊂ߪ‫ޔ‬ᅧᆼߩ૕㊀Ⴧട㊂߆ࠄᦼJ BMI2ಽ࿁yߣõ ࠍ␜ߒ‫ޔ‬uᦼߢߪ‫ޟ‬⢈ḩ‫ ޕߚߒߣޠ‬uᦼߩ'¥[޽ߚࠅߩ૕㊀Ⴧട㊂ࠍᒁ޿ߚ ᅧᆼߣᱜ ‫ޔ‬ᐕDߣಽ࿁yߣ߽ߩߣߒߡ¢಴ߒߚ‫ޕ‬õ ࠍ␜ߒߚ‫ޕ‬InstituteofMedicine.
Subcommitteeon
Nutritional
Status and Weight Gain in
Pregnancy.
Nutrition
duringpregnancy: part Ò , weight gain.
National
AcademyPress,
Washington
D.C.,
'990.

ᄖîฃ¦ߩ૕㊀3ቯ߆ࠄ૕㊀Ⴧട3ߣ ૕㊀Ⴧട㊂ߪ''.'9Ö3.45kgߢ޽ߞߚ‫ޕ‬
૕㊀Ⴧട㊂ࠍ¢಴ߒߚ‫ޕ‬૕㊀Ⴧട㊂ߩ ᅧᆼᦼ[ߢ‫⇣ޟ‬ᏱჇട‫ߦޠ‬LFD*7 ߇ᐔ  ( 6 7 ¤ ਄ Ⴧ ട ߒ ߚ ⠪ ࠍ ‫ ⇣ ޟ‬Ᏹ Ⴧ ᄙߊ‫ޟޔ‬ñò‫ߦޠ‬SFD*6 ߇ᄙ߆ߞߚ‫ޕ‬ᅧട‫ޔޠ‬ᐔ-67¤ਅߢ޽ߞߚ߽ߩࠍ ᆼ∝㧔ᅧᆼ∝㧕2⇣Ᏹಽ‫ޟ‬ñò‫ޕߚߒߣޠ‬ᅧᆼߩᦼJuᦼߩ૕ 2¨ಽ2¢ ࡯ᜰy2಴㊂ߪ㊀Ⴧട3ߩᐔ1ࠍߘࠇóࠇ®¢ߒ‫ޔ‬ᐔ ૕㊀Ⴧടߣ !ߥߒ‫ᦼޕ‬Juᦼߢ૕㊀Ⴧ
(67¤਄Ⴧടߒߚ⠪ࠍ‫⇣ޟ‬ᏱჇട‫ ޠ‬ട3‫ޟ‬ñò‫ߦޠ‬ᅧᆼ∝㧔ᅧ‫ޔ‬ᐔ-67¤ਅߢ޽ߞߚ߽ߩࠍ‫ޟ‬ñ ᆼ   ∝ 㧕 ߇ ᄙ ߆ ߞ ߚ ‫ ⇣ ޟ ᦼ  ޕ‬Ᏹ Ⴧò‫ޕߚߒߣޠ‬ട‫ߦޠ‬LFD 7 ߇ᄙߊ‫ޔ‬SFD 6 ߇wߥ߆ߞ
ߚ‫ޕ‬

ߥߒ

Ð©¨Ñሶ,7ᅧᆼ\૕૕㊀Ⴧട ',3'4é
㊂ ߦ
ߔ ࠆ ᬌ ⸛  \ ᕈ ↢
'977;'7:85-89' NICU*↢ఽv≮.Ñ 2ÑIUGR*ሶúౝ⢝ఽ⊒xÑÑ 3ÑSGA*small-for-gestational ageÑÑ 4ÑLBW*low-birth weightÑ

25

24

23

22

ᅧᆼsᦼ߆ࠄÚ᦬'࿁‫ޔ‬îᔕᄢቇï/∛Ê ᅧᆼ'0ß'2¥߹ߢߪߣÏߤᅧᆼߩ
ᄖîߢ૕㊀3ቯࠍⴕ޿‫ޔ‬ḩᦼ⢝↢ఽࠍ ૕㊀ߣߴ‫ޔ‬ᄌൻ߇ߺࠄࠇߥ߆ߞߚ‫ޕ‬ಽ8ߚéߦߟ޿ߡᅧᆼ᦬#૕㊀ჇടÓÔࠍ ߹ߢߩᐔ૕㊀Ⴧട㊂ߪ''.7kgߢ޽_ᚑߒߚ‫ޕ‬૕㊀ჇടߣLFD/SFD 7 6ߣߩ ࠅ‫ޔ‬૕㊀Ⴧട㊂߇5ß'2kgߩว‫ఽޔ‬૕㊀! ‫ ⇣ ⑼ ↥ ޔ‬Ᏹ ߣ ߩ ! ߦ ߟ ޿ ߡ ⸃ " ߒ ߣߩ Áyr=0.59ߢ޽ߞߚ߇‫'ޔ‬2kgࠍ
C߃ࠆߣr=0.3'ߣૐਅߒߚ‫ޕ‬ߚ‫ޕ‬Í਄ÎᅧᆼJಽJ↥Ï⚻nߩ\ 2,000 é ߥߒ
૕૕㊀ߩᄌ¬ߣߘߩ·¸↥ᇚੱ⑼ 㧔 '973 ß≮ '976;33:88-9''974㧕

Wong W, Tang NL, Lau TK, Wong TW.  ⢝ ಽ  BMI'9.0£ḩࠍ‫ ߿ޟ‬37ß4'¥ߢ૕㊀2500gß4000gߩ↢ఽࠍಽ ‫⦟ޟ‬øߥᅧᆼòÁþߩᐔ૕㊀Ⴧട㊂ߪ
A new recommendation for maternal 908éߖ ‫' ޔ ޠ‬9.0 ¤ ਄ ߒ‫ޔ‬ᅧᆼว∝ߩ⷗ࠄࠇߥ߆ߞߚ‫' ⦟ޟ‬3.8Ö4.2kgߢ޽ߞߚ‫ޕ‬sᦼߩ'¥[޽ߚ
weight gain in Chinese women. J
23.5 ¤ ਅ ࠍ ‫ ޟ‬¥ߟ øߥᅧᆼòÁþ504éߩs࡯k߆ࠄÌí ࠅߩ૕㊀Ⴧട㊂ߪ0.06Ö0.35kg‫ߪᦼޔ‬Am Diet Assoc. 2000;'00:79'-796.
߁ ‫ ޔ ޠ‬23.5 ¤ ਄ࠍ ⊛ߥ૕㊀Ⴧട㊂ࠍ߼ߚ‫⦟ޟޕ‬øߥᅧᆼ 0.5' Ö 0.33kg ‫ ޔ‬u ᦼ ߪ 0.45 Ö 0.22kg ߢ‫ޟ‬⢈ḩ‫ ޕߚߒߣޠ‬òÁþߦ߅ߌࠆ૕㊀Ⴧട㊂ߩ25ß75Ð࡯ ޽ ߞ ߚ ‫ ߩ ޠ ߖ ߿ ޟ ޕ‬Ì í ૕ ㊀ Ⴧ ട ㊂ ࠍ"  k ࡞ 1 ࠍ  ߼ ‫ ࠍ ࠇ ߎ ޔ‬ၮ Ḱ ߣ ߒ '3.0 ß '6.7kg ‫ ޟ ޔ‬¥ ߟ ߁ ‫'' ࠍ ޠ‬.0 ß '3.8Ö
0.06Ö0.35 0.5'Ö0.33'2
ߚ‫ޕ‬'6.4kg‫ޟޔ‬⢈ḩ‫ࠍޠ‬7.'ß'4.4kgߣߒߚߣ
4.2
4
(ౣì)
㧔kg㧕
ߎࠈ‫ޔ‬૕㊀Ⴧട㊂ਇ⿷ߩวߩLBW ߩ 㧔kg㧕 㧔kg㧕
¹Ì Í2 ߪ2.76‫ޔ‬૕㊀Ⴧട㊂noߩว ߩ ಽ   u ౉ ߩ  ¹ Ì  Í 2 ߪ 2.'6 ߢ޽ߞߚ‫ޕ‬VÃ<಴Ä

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3ÑSGA*small-for-gestational ageÑÑ

4ÑLBW*low-birth weightÑ 5ÑHBW*high-birth weightÑ 6ÑSFD*small-for-dateÑ

ᅧᆼ'4,'7,20,25,30,35¥ߩ6࿁ߦࠊ ߚߞ 7ß'0¥߆ࠄ20¥ ߹ߢߩ\૕૕㊀Ⴧട3ߡ‫ޔ‬⢝ఽߣ⢝hߩ⊒x⁁ᴫࠍCøùߢ 㧔 4 ¥ [ ޽ ߚ ࠅ ) ࠍ 0.5kg ¤ ਅ ‫ ޔ‬0.5' ß
3ቯߒߚ‫ޕ‬'.00kg‫'ޔ‬.00ß'.50kg‫'ޔ‬.5'kg¤਄ߩ4
ߢLߒߚߣߎࠈ‫ޔ‬35¥ߩ⢝hኈ㊂‫ޔ‬⢝ఽߩú:ߣ߽ߦ૕㊀Ⴧട3߇޿ߤ
ᄢ߈߆ߞߚ‫ޕ‬⢝hኈ㊂ߪఽ૕㊀ߣᱜߒߚ‫ޕ‬Í' Cl*Çb[ ÑÍ2Ñ¹Ì*޽ࠆY㧔Oሶ㧕ߦRߡߪ߹ࠆੱ߇‫ߩߘޔ‬Yߦ޽ߡߪ߹ࠄߥ޿ੱߦߴߡ૗޽ࠆࠍîߚߔᕈ߇޿߆ࠍ␜ߔᜰ

2ÑIUGR*ሶúౝ⢝ఽ⊒xÑÑ

Thame M, Osmond C, Bennett F, '5 ß 40 4
Wilks R, Forrester T.
Fetal ߹ ߢ ߩ ᅧ
growth is directly related to ᇚ374é
maternal
anthropometry
andplacental volume.
Eur J Clin
Nutr. 2004 ;58:894-900.

Hickey CA, Cliver SP, Goldenberg ÷ ੱ ᅚ ᕈ BMI'9.8£ḩࠍ‫ ߿ޟ‬IOMߩ૕㊀ჇടၮḰߣߴߡఽ૕㊀ߩ ÷ੱᅚᕈߢߪ⢈ḩ⠪ߢ6kg¤਄‫ޔ‬૕㊀߇Ⴧ ÷ੱ'2.5
2
RL, Kohatsu J, Hoffman HJ. ߩ ᱜ ᦼ ↥ ߖ ‫' ޔ ޠ‬9.8 ¤ ਄ ߣLߒߚ‫ޕ‬߃ ߚ  ว ‫ ޔ‬IUGR ఽ ߩ ഀ ว ߇ ­ ੱ ߦ  㧔kg㧕‫ޔ‬­ੱ'3.'
Prenatal weight gain, term birth ಽ803é 26.0 ¤ ਅ ࠍ ‫ ޟ‬¥ߟߴ‫ޔ‬ªqߦwߥ߆ߞߚ㧔4.2%''.8%㧕
㧔kg㧕
weight,and
fetal
growth ߣ ­ ੱ ᅚ ߁ ‫ ޔ ޠ‬27.0 ¤ ਄
retardation
amonghigh-risk ᕈಽ365 29.0 ¤ ਅ ࠍ ‫ ޟ‬n૕
multiparous
black
and
white é㊀ ‫ ޔ ޠ‬29.0 ¤ ਄ࠍ
women.
ObstetGynecol.
‫ޟ‬⢈ḩ‫ޕߚߒߣޠ‬'993;8':529-535.

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Abrams B, Selvin S. Maternal ­ ੱ  ⢝weight gain pattern and birth ಽ  4,420
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